To the Editor: The analysis of the Medicare Current Beneficiary Survey by Dr Madden and colleagues1 reported an overall decrease in cost-related medication nonadherence (CRN) following implementation of Medicare prescription drug plans. The authors stated that it is crucial to identify specific qualities of Medicare prescription drug plans that contributed to decreases in CRN.
No reference was made to the provision of medication therapy management, a service required by Medicare that is intended to improve medication use. Medication therapy management is available to patients with multiple chronic illnesses who are taking multiple medications with an expected annual medication expenditure of at least $4000.2 The authors noted that of patients included in the analysis, those with 4 or more morbidities did not experience significant decreases in CRN.1 This group of patients would likely gain the most benefit from effective medication therapy management due to increasingly complex medication regimens.
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