I read your article “Strategies for Reducing Costs in Your Community: The Grand Junction Experience” [July/August 2010] with interest. I am a family physician in a town of about 60,000 people. I work in a community hospital that is two miles from a large university hospital. I love the idea of reducing medical costs. I use my own handheld computer to find generics. I am on the board of our community hospital IPA. Our IPA does not have the funds to do some of the things yours does, and we don't have one local health plan that works with the IPA and physicians to reduce costs. Is what you describe reproducible in most communities?

Authors' response:

Consider forming a therapeutics committee, composed primarily of practicing primary care physicians, an emergency physician, an allergist, a hospitalist and a pharmacist, for your IPA. Gather data from your IPA as to what drugs are the major cost drivers for the IPA or for a specific health plan. Working with this committee and with this information, you should be able to identify some innovative ways your IPA can reduce unnecessary spending on drugs. Our IPA started out in this fashion, using volunteer committee members and thus not costing the IPA anything. If you can address the health care costs for one of your health plans, it will likely result in positive benefits for many of the health plans, since using generic drugs in place of expensive patented drugs represents cost savings for virtually every health care plan in your area. Simply sending lists of the top 10 drug costs to participating physician members of a health plan can be powerful information. Finally, you need to make the health plans aware of what you are doing to reduce overall health care costs and negotiate with them for financial support so that your IPA's efforts can be ongoing.