LAUSR

We appreciate the interest of Drs. Yanofsky and Giannouli in our work and their comments. Our article's stated aim was to describe how neurologists, working within the existing US health care system, could help bring down medical costs without compromising quality of care.1 It was not our intent to address ways to fix systemic flaws in the health care delivery system in the United States or elsewhere. This could be the subject of a separate article with a different set of recommendations, which could include such items as allowing Medicare to negotiate drug prices, mandating transparency in drug costs to insurance carriers and specialty pharmacies, stimulating free market competition among generic drug manufacturers, easing restrictions on insurance coverage for off-label agents with solid evidence of efficacy, and stopping direct-to-consumer advertising (among others).