What are we going to do about the price of drugs? If any economists are reading this, not that I said price, not cost. The Pennsylvania experience gives some important lessons - Pennsylvania Struggles to Repair Model Prescription Aid Program

The average number of prescriptions filled for each person in the program now exceeds 3.5 a month, up from 2.5 in 1997 and just 2 in 1987. The state pays an average of $42 for each prescription, up from $27 in 1997 and $14 in 1987.

"The big problem we have, which causes escalating costs, is utilization," Mr. Snedden said. "People are using more and more prescription drug products. If we could get utilization under control, drug prices would not be such a big problem."

Ray Landis, a lobbyist for AARP here, said the situation in Pennsylvania should teach federal officials to be cautious in making assumptions and projections. "In our program," Mr. Landis said, "both utilization and price increases have been much greater than anticipated."