Cutting Copays for Cholesterol Drugs May Save Money

Fewer hospitalizations and use of emergency room could save $1 billion a year

WEDNESDAY, Jan. 18 (HealthDay News) -- If copayments for cholesterol-lowering therapy were eliminated or reduced for those patients most in need, it could boost compliance and save up to $1 billion a year by reducing hospitalizations and use of emergency departments, according to a study in the January issue of the American Journal of Managed Care.

Dana P. Goldman, Ph.D., of the RAND Corporation in Santa Monica, Calif., and colleagues studied claims data from 88 health plans covering 62,274 patients who began taking cholesterol drugs between 1997 and 2001. They studied the association between copayments and compliance within the first year of treatment, and then looked at the link between compliance and hospital use over the first four years of treatment.

When copayments were doubled from $10 to $20, the number of fully compliant patients dropped by 6% to 10%. In high-risk patients, those who were fully compliant had 357 fewer hospitalizations per 1,000 patients and also made 168 fewer ED visits. For low-risk patients, compliance resulted in 42 fewer hospitalizations and 21 fewer visits. Eliminating copayments for high-risk patients and increasing them for low-risk patients would avert 79,837 hospitalizations and 31,411 ED admissions annually, the report indicates.

"The challenge for the health care system is to make patients more sensitive to the cost of treatment without encouraging them to forego cost-effective care," the authors conclude. "Strategically reducing copayments for patients who are most at risk can improve overall compliance and reduce use of other expensive services."

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