The ALLOC function does the heavy lifting, but that is inevitable: Only by walking the entire MCB chain can DOS coalesce all eligible memory and ensure that the largest free block is found. This means that calling the ALLOC function can be somewhat expensive if the MCB chain is long. In practice, there are unlikely to be more than a few dozen MCBs, even in a heavily loaded system.
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To be sure, neither tool is costless. Formulary exclusions can inconvenience some patients, and encouraging patients to use lower-cost pharmacies can mean switching where they fill their prescriptions. But every healthcare system faces a choice: tolerate some limits or accept higher prices across the board. Negotiation requires leverage, and leverage requires the ability to say no—and to reward lower-cost drugs and providers with more business.