James X Zhang
The cost barrier to medications is a persistent and serious problem among the U.S. elderly population. Twenty-six percent of the elderly do not take medication as prescribed due to a cost barrier [1]. This is not surprising as many elderly patients depend on a small amount of fixed income from social security and struggle on a day-to-day basis to make difficult choices between meeting the basic needs of daily life and filling prescriptions. The Medicare Part D program, a subsidized drug program, aims to significantly improve access to outpatient prescription drug benefits for millions of elderly Americans [2]. While overall utilization increased after the institution of Part D, [3] costrelated medication non-adherence (CRN) has not deceased or has even worsened among the sickest patients, including those with multiple chronic conditions, depression, and stroke survivors [4-6].