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Unlocking health equity by eliminating copayments for essential antihypertensive medications
Thomas R Frieden1, Renu Garg1, Bolanle Banigbe1
1Resolve to Save Lives, New York, NY, USA.
Insights
Eliminating copayments for blood pressure medication improves adherence and control, especially in low-income nations. This strategy is key to managing hypertension, the leading global cause of death.
Area of Science:
- Public Health
- Cardiovascular Medicine
- Health Economics
Background:
- Hypertension is the leading global cause of death, disproportionately affecting low- and middle-income countries (LMICs).
- Effective hypertension management, including medication adherence, is crucial for preventing severe health outcomes and reducing healthcare costs.
- Current hypertension control rates remain low worldwide, particularly in LMICs, highlighting significant treatment gaps.
Purpose of the Study:
- To evaluate the impact of eliminating patient copayments for antihypertensive medications on adherence and hypertension control.
- To assess the feasibility and economic implications of providing free point-of-care medications in LMICs.
- To explore strategies for integrating medication access into comprehensive primary healthcare systems.
Main Methods:
- This study synthesizes evidence on the effects of medication cost reduction on adherence and health outcomes.
- Economic analysis explores the cost-effectiveness and financial sustainability of eliminating copayments.
- Qualitative assessment considers implementation challenges and systemic requirements for successful integration.
Main Results:
- Eliminating copayments for antihypertensive drugs significantly increases patient adherence and improves hypertension control rates.
- This intervention is a cost-effective strategy that can reduce the burden of cardiovascular diseases and associated healthcare expenditures.
- While feasible, implementing free medication access requires strategic investment and careful planning to sustain primary healthcare systems.
Conclusions:
- Removing out-of-pocket costs for blood pressure medications is a powerful, underutilized strategy to improve hypertension control globally.
- This approach can advance universal health coverage and alleviate economic hardship for patients in LMICs.
- Free point-of-care medication access should be part of a multifaceted approach to overcome systemic barriers in hypertension management.
Abstract:
Hypertension kills more people than any other condition; approximately 80% of deaths occur in low- and middle-income countries (LMICs). Only about 1 in 5 adults with hypertension worldwide and less than 1 in 10 in LMICs have their condition controlled. Adherence to antihypertensive medications increases control and decreases hospitalizations, strokes, heart attacks, and health care costs. Eliminating patient copayments for antihypertensive medications increases adherence and hypertension control. This powerful but underutilized strategy can advance universal health coverage and reduce economic hardship. Medication access with no out-of-pocket cost to patients is feasible and economically sound, but requires increased investment and careful implementation to avoid unintended consequences of reducing flexible funding needed for primary health care systems. Provision of medications that are free to patients at the point of care should be part of a multi-component, sustainable approach to addresses systemic barriers to treatment of hypertension, the world's leading cause of death.
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