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Drug copayment and adherence in chronic heart failure: effect on cost and outcomes

J Alexander Cole1, Heather Norman, Lisa B Weatherby

  • 1Division of Epidemiology, i3 Drug Safety, Auburndale, Massachusetts 02466, USA. alex.cole@i3drugsafety.com

Pharmacotherapy
|July 26, 2006
PubMed

Insights

Higher prescription copayments for chronic heart failure (CHF) patients led to lower medication adherence. This decrease in adherence, though small, did not impact overall healthcare costs but significantly increased the risk of CHF hospitalizations.

Area of Science:

  • Health Economics
  • Cardiology
  • Pharmacoeconomics

Background:

  • Chronic heart failure (CHF) management requires consistent medication adherence.
  • Prescription drug copayments are a significant factor influencing patient adherence to prescribed therapies.
  • Understanding the link between copayments, adherence, and health outcomes is crucial for effective CHF patient management.

Purpose of the Study:

  • To investigate the association between prescription drug copayments, medication adherence, and subsequent health outcomes in patients diagnosed with chronic heart failure (CHF).

Main Methods:

  • Retrospective cohort study utilizing data from a large national health insurance plan.
  • Analysis included patients with CHF receiving commercial and Medicare supplemental benefits.
  • Medication adherence was measured using the medication possession ratio for beta-blockers and angiotensin-converting enzyme (ACE) inhibitors.

Main Results:

  • A $10 increase in copayment was associated with decreased adherence (2.6% for ACE inhibitors, 1.8% for beta-blockers).
  • This adherence reduction did not significantly alter total healthcare costs but was linked to increased CHF hospitalization risk (6.1% for ACE inhibitors, 8.7% for beta-blockers).

Conclusions:

  • Elevated drug copayments correlate with reduced medication adherence in CHF patients.
  • While copayment-driven adherence changes had minimal impact on overall healthcare expenditures, they were sufficient to elevate the predicted risk of CHF-related hospitalizations.
Abstract

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