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Eliminating medication copayments reduces disparities in cardiovascular care

Niteesh K Choudhry, Katsiaryna Bykov, William H Shrank

    Health Affairs (Project Hope)
    |May 7, 2014
    PubMed

    Insights

    Reducing medication copayments after myocardial infarction significantly improved adherence and clinical outcomes for nonwhite patients, potentially reducing cardiovascular health disparities.

    Area of Science:

    • Cardiovascular Medicine
    • Health Services Research
    • Health Disparities

    Background:

    • Racial and ethnic disparities in cardiovascular care are prevalent in the U.S.
    • Minority patients are less likely to receive secondary prevention therapies post-myocardial infarction.
    • The effect of reduced copayments on these disparities is not well understood.

    Purpose of the Study:

    • To investigate the impact of reduced medication copayments on adherence and clinical outcomes.
    • To determine if reduced copayments can mitigate racial and ethnic disparities in cardiovascular care.

    Main Methods:

    • Analysis of data from the Post-Myocardial Infarction Free Rx Event and Economic Evaluation (MI FREEE) trial.
    • Self-reported race and ethnicity data were used to stratify participants.
    • Medication adherence, clinical outcomes, and healthcare spending were compared between groups.

    Main Results:

    • Full drug coverage improved medication adherence for all patients.
    • Nonwhite patients experienced a 35% reduction in major vascular events or revascularization with full coverage.
    • Full coverage reduced total healthcare spending by 70% for nonwhite patients, with no significant effect on white patients.

    Conclusions:

    • Lowering medication copayments after myocardial infarction may be an effective strategy to reduce racial and ethnic disparities.
    • Financial barriers to essential medications disproportionately affect minority populations.
    • Targeted financial assistance can improve cardiovascular outcomes and reduce healthcare costs in underserved groups.

    Keywords:
    DisparitiesInsurance Coverage < InsurancePharmaceuticals

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