insurance instead of regular co-payment. All of these implications have helped slow the long-term growth of medical expenses but in doing so we have lost the use of effective medications. Many individuals in American admit to not taking their prescription drugs as they were told to because they simply cannot afford them. In other studies, patients were prescribed a more expensive brand name drug rather than the cheaper generic drug and there was less compliance seen. As a consequence, “Nonadherence due to all causes has been established to contribute to $105 billion unavoidable health care costs annually” (Kesselheim et al). Another consequence includes the use of coupons to reduce the price for drug costs which may initially seem like a good idea but in the end increases healthcare spending. The use of coupons will most likely leave the insurer choosing the higher priced drug. This has become rather common for the costly brand name drugs even when there’s less expensive generic drug alternatives available. Within healthcare budgets, many components within often have to be decreased or increased. States with more costly drugs in the Medicare programs often have to reduce other services or increase health care eligibility requirements. For example, there are several states with Medicare programs that have policies that restrict sofosbuvir, an antiviral medication, that include denying coverage for any individual that uses alcohol or drugs (Kesselheim et al). • Analytic- what are the consequences? • Evaluative- value judgements about consequences •Efficiency—maximize satisfaction(utility) •Equity—maximize equality, fairness, social justice •Personal freedom—maximize individual choice •Community—maximize solidarity>