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Lower Drug Copayments Improve Patient Adherence

Non-adherence dropped 7 to 14 percent in four classes of drugs after copays were slashed

WEDNESDAY, Jan. 9 (HealthDay News) -- Reducing drug copayments increased patients' adherence to medications, according to a report published in the January/February issue of Health Affairs.

Michael E. Chernew, Ph.D., of Harvard Medical School in Boston, and colleagues analyzed data from adults working for a company that lowered copays for five classes of medications (along with their dependents), and data on those at a control company. The medications were ACE inhibitors/angiotensin receptor blockers (ARBs), beta-blockers, diabetes medications, statins, and inhaled corticosteroids. Copays for generics dropped from $5 to zero, and copays for brand-name drugs dropped 50 percent.

The investigators found a clear positive effect on adherence for the diabetes drugs, beta-blockers and ACE inhibitors/ARBs, and a positive effect for statins. The effect on corticosteroids was not statistically significant. In the four classes with a significant effect, non-adherence was reduced by 7 to 14 percent.

"As health care cost pressures mount, the prevailing cost containment approaches increasingly shift costs to patients. The evidence is strong, however, that increased cost sharing leads to decreased adherence to potentially life-saving medications, with likely serious deleterious health effects. These adverse health outcomes can be mitigated if cost-sharing provisions are explicitly designed with value in mind," the authors write.

Two study co-authors have provided consulting services to Hewitt Associates LLC, another is clinical director for the Center for Value-Based Insurance Design, and the study was supported by GlaxoSmithKline and Pfizer.

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