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The emphasis on eliminating racial and ethnic disparities in healthcare has received national attention, with various policy initiatives addressing this problem and proposing solutions. However, in the current economic era requiring tight monetary constraints, emphasis is increasingly being placed on economic efficiency, which often conflicts with the equality doctrine upon which many policies have been framed. The authors’ review aims to highlight the disparity implications of one such policy provision – the predominantly utilization-based eligibility criteria for medication therapy management services under Medicare Part D – by identifying studies that have documented racial and ethnic disparities in health status and the use of and spending on prescription medications. Future design and evaluation of various regulations and legislations employing utilization-based eligibility criteria must use caution in order to strike an equity–efficiency balance.


This is a pre-copy-editing, author-produced PDF of an article accepted for publication in Expert Review of Pharmacoeconomics and Outcomes Research, volume 13, issue 2, in 2013 following peer review. The definitive publisher-authenticated version is available online at DOI: 10.1586/erp.13.6.


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