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Full Rx Coverage Ups Outcomes for Patients Discharged After MI

Full coverage associated with greater quality-adjusted survival, less resource use per patient

WEDNESDAY, May 6, 2015 (HealthDay News) -- For patients discharged from hospital after myocardial infarction, full prescription coverage is associated with improved health outcomes and less resource use, according to research published online May 5 in Circulation: Cardiovascular Quality and Outcomes.

Kouta Ito, M.D., from Harvard Medical School in Boston, and colleagues developed a Markov model simulating a hypothetical cohort of commercially insured myocardial infarction patients who were discharged from hospital. Patients received β-blockers, renin-angiotensin system antagonists, and statins with full coverage (no cost sharing) or usual coverage (at the current level of insurance coverage). The incremental cost-effectiveness ratio, as measured by cost per quality-adjusted life-year gained, was the main outcome measured.

The researchers found that patients receiving full coverage lived an average of 9.60 quality-adjusted life-years after the event and incurred costs of $167,401, while those with usual coverage lived 9.46 quality-adjusted life-years and incurred costs of $171,412. Full coverage would result in greater quality-adjusted survival and less resource use per patient, compared with usual coverage. The results were sensitive to variations in the risk reduction for post-myocardial infarction events associated with full coverage.

"Providing full prescription drug coverage for evidence-based pharmacotherapy to commercially insured post-myocardial infarction patients has the potential to improve health outcomes and save money from the societal perspective over the long term," the authors write.

Several authors disclosed financial ties to medical insurance and health care industries.

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