Full Coverage for Preventive Medications after Myocardial Infarction

• Published in: The New England journal of medicine Vol. 365; no. 22; pp. 2088 - 2097
• Main Authors: Choudhry, Niteesh K, Avorn, Jerry, Glynn, Robert J, Antman, Elliott M, Schneeweiss, Sebastian, Toscano, Michele, Reisman, Lonny, Fernandes, Joaquim, Spettell, Claire, Lee, Joy L, Levin, Raisa, Brennan, Troyen, Shrank, William H
• Format: Journal Article
• Language: English
• Published: Waltham, MA Massachusetts Medical Society 01.12.2011
• Subjects: Adrenergic beta-Antagonists - economics; Adrenergic beta-Antagonists - therapeutic use; Adult; Aged; Angiotensin; Angiotensin-Converting Enzyme Inhibitors - economics; Angiotensin-Converting Enzyme Inhibitors - therapeutic use; Biological and medical sciences; Cardiology. Vascular system; Coronary heart disease; Cost control; Deductibles and Coinsurance; Drug Costs - statistics & numerical data; Drug therapy; Drug Utilization - economics; Drug Utilization - statistics & numerical data; Female; General aspects; Health Expenditures - statistics & numerical data; Heart; Heart attacks; Humans; Hydroxymethylglutaryl-CoA Reductase Inhibitors - economics; Hydroxymethylglutaryl-CoA Reductase Inhibitors - therapeutic use; Insurance Coverage; Insurance, Pharmaceutical Services; Male; Medical sciences; Medication Adherence - statistics & numerical data; Middle Aged; Myocardial infarction; Myocardial Infarction - drug therapy; Myocardial Infarction - mortality; Pharmacy; Prevention and actions; Public health. Hygiene; Public health. Hygiene-occupational medicine; Retreatment; Statins; United States; United States; United States > US; Myocardial infarction; Medicine; Drug; Prevention; Chemotherapy; Treatment; Cardiovascular disease; Coverage; Coronary heart disease; Myocardial disease
• ISSN: 0028-4793; 1533-4406
• DOI: 10.1056/NEJMsa1107913

In this trial, eliminating copayments for medications after hospitalization for MI did not reduce the primary outcome (first major vascular event or revascularization) but did improve medication adherence and secondary outcomes, without significantly increasing total spending. The use of medications based on solid clinical evidence has contributed substantially to reductions in cardiovascular morbidity and mortality. 1 , 2 For patients with acute myocardial infarction, prescribing of these highly effective therapies is now nearly universal at the time of hospital discharge in the United States, 3 , 4 but important gaps in care persist thereafter. Some patients never fill their first prescriptions, 5 and most have poor adherence to medication regimens over time. 6 Drug costs are central among the many factors that contribute to medication underuse. 7 , 8 A third of Americans report that they did not fill a prescription or reduced the . . .