The purchase of `lifestyle' enhancing therapies by purchasers such as patients and insurers is projected by some to double the level of US spending on pharmaceuticals over the coming 5 to 10 years. Health plans struggling with the balance between the ability to increase medical premiums and the escalation of medical costs have taken a tough stance on the coverage of these therapies which, in the opinion of many, are not medically necessary for most of the US population. Regardless of whether current health insurance coverage policies survive, the bulk of the spending for these agents is likely to be passed on to employers through increased premium payments or become the responsibility of the consumers themselves. Which agents should be included in the lifestyle drug category is a hotly debated topic with many health plans pushing to include medically necessary agents that offer convenience in drug administration as well as those that clearly affect just the patients appearance. Exactly where and how the line will be drawn is likely to be a question that is discussed well into the next millennium.
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