Copayment Elimination Ups Post-MI Medication Adherence

Enhanced coverage also decreases patient spending without increasing overall health costs

MONDAY, Nov. 14 (HealthDay News) -- For patients discharged after a myocardial infarction, the elimination of copayments for medications improves adherence, but does not significantly reduce the rates of first major vascular event or revascularization, according to a study published online Nov. 14 in the New England Journal of Medicine to coincide with presentation at the American Heart Association's Scientific Sessions 2011, held from Nov. 12 to 16 in Orlando, Fla.

Niteesh K. Choudhry, M.D., from the Brigham and Women's Hospital in Boston, and colleagues investigated whether eliminating out-of-pocket costs would increase medication adherence and improve outcomes in patients after myocardial infarction. Participants were randomized to receive full prescription coverage (1,494 plan sponsors with 2,845 patients), or usual prescription coverage (1,486 sponsors with 3,010 patients). The first major vascular event or revascularization was the primary outcome. Rates of medication adherence, total major vascular event or revascularization, the first major vascular event, and health expenditures were the secondary outcomes.

The investigators found that the usual prescription group had adherence rates ranging from 35.9 to 49.0 percent, with significantly higher rates in the full coverage group (4 to 6 percent higher). The two groups did not differ significantly for the primary outcome (hazard ratio [HR], 0.93; P = 0.21). The full coverage group did have lower total major vascular events or revascularization rates and first major vascular event rates (HRs, 0.89 and 0.86, respectively; P = 0.03 for both). Total spending was not significantly increased by eliminating copayments, but patient costs for drugs and other services were significantly reduced.

"The elimination of copayments for drugs prescribed after myocardial infarction did not significantly reduce rates of the trial's primary outcome," the authors write.

Several authors disclosed financial relationships with pharmaceutical and medical insurance companies, including Aetna, which partially funded the study.

Full Text
More Information

Copyright © 2011 HealthDay. All rights reserved.

Powered by

jQuery UI Accordion - Default functionality

For life-long learning and continuing professional development, come to Lippincott's NursingCenter.

Nursing Jobs Plus
Featured Jobs
Recommended CE Articles

Debunking Three Rape Myths
Journal of Forensic Nursing, October/December 2014
Expires: 12/31/2016 CE:2.5 $24.95

Drug updates and approvals: 2014 in review
The Nurse Practitioner, 13December 2014
Expires: 12/31/2016 CE:3 $27.95

Can Food Processing Enhance Cancer Protection?
Nutrition Today, September/October 2014
Expires: 10/31/2016 CE:2 $21.95

More CE Articles

Subscribe to Recommended CE

Recommended Nursing Articles Evidence Based Practice Skin Care Network NursingCenter Quick Links What’s Trending Events