State Legislation and Use of Feeding Tubes in Cognitively Impaired Patients

in care for depression because a patient cannot afford the cost of antidepressant medications also could be considerably detrimental to care. Without a doubt, depression is an important health problem, and in many cases patients may benefit from long-term treatment. We did not measure medication use or health outcomes after patients exhausted benefits. Other studies, however, have found that patients often do decrease use with higher out-ofpocket drug costs. Most important, the disruption of medication use due to cost, even for potentially short-term or intermittent conditions such as pain or inflammation, also could have an impact on quality of care or quality of life. Since drug benefits will always be limited in some manner, the next step is to explore how to balance cost and health benefits to achieve more cost-efficient use of medications.