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This addresses a longstanding problem: Part D did not originally have a true out-of-pocket maximum enrollees with very high drug costs (for instance, expensive cancer medications or multiple brand-name drugs for chronic diseases) could end up spending thousands per year even after reaching the catastrophic phase, since they kept paying 5% coinsurance on each refill with no limit

4 Combining ED, hospital, and poisoning databases, an estimated 450 deaths occur each year in the United States due to acetaminophen overdose, and approximately 100 of them are unintentional, primarily due to supratherapeutic dosing of child preparations