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Executive Summary

NATIONAL DRUG FORMULARY COULD LEAD TO DRUG "MISUSE" BY ELDERLY if physicians are pushed to select drug regimens from a limited group of drugs, Peter Lamy, PhD, director of the University of Maryland Center for the Study of Pharmacy and Therapeutics and the Elderly, said at a seminar on Capitol Hill Sept. 10. Lamy said a rigid national formulary could produce problems due to the difficulty of tailoring drug regimens to the elderly's special needs. Speaking at an Institute for Alternative Futures Foresight Seminar on "Long-Term Care, Problems and Opportunities," Lamy said that any "national formulary imposed on us by Congress will give us much more drug misuse because in a sophisticated area, such as long-term care, we use drugs based on the toxicity profile, whether it's the antipsychotics or the antidepressants." If the formulary sanctioned products in each category are limited to only one or two items, Lamy maintained, "then there remains [the potential] to do more harm than good by saving some money." He noted that problems such as actual dosage size could get in the way of appropriate treatment of the elderly. Procter & Gamble Corporate Director-Worldwide Regulatory Affairs Michael Young, MD/PhD, predicted that "in the next decade, [there will be] a considerable increase in direct-to-patient information coming from the industry, around both the specific therapy itself, and more importantly around the disease." P&G's Young said there is potential for "major advances" in developing a specialized field of informational transfer and patient education, suggesting that those skilled in medical practice are not always the "best communicators." Young did not describe the form such educational efforts would take, but noted that P&G has a "long, long history in promotion to the public and interest in the consumer." He also noted that "a lot of health care is going to be delivered beyond just prescription drugs" for acute care problems. The "fit elderly" will be a "bigger and bigger part of our population. The focus on health and keeping their lifestyles [active] is going to be one of the major demands on the health care system."

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