Reducing Co-pays for Cardiovascular Meds: More Bang for the Buck?
Cutting co-payments for statins and clopidogrel was associated with improvements in adherence and resource utilization but no change in overall spending.In a recent randomized trial, provision of evidence-based drug therapy after myocardial infarction at no cost to the patients, while failing to show benefit with regard to the primary composite endpoint, was associated with improvement in both adherence and vascular events (JW Cardiol Nov 14 2011). Now, the same research group has studied the effects of reducing co-payments for statins and clopidogrel on adherence, resource utilization, and events in 2830 employees of a large company as compared with 49,801 employees of companies that did not change their co-payment policies. Pharmacy and medical services claims data from 1 year before through 1 year after the change in co-payment policy were included in the analysis.
In the intervention group, the monthly rate of prescription filling increased significantly for both drugs after the co-payment reduction (by 7% for statins and 6% for clopidogrel). Compared with the control patients, intervention patients also had significantly fewer physician visits, hospitalizations, and emergency department visits after the change, although the rates of major coronary events and revascularizations did not differ between the two groups. Combined insurer and patient spending was similar before and after the co-payment reduction.
Choudhry NK et al. The impact of reducing cardiovascular medication copayments on health spending and resource utilization. J Am Coll Cardiol 2012 Oct 3; [e-pub ahead of print].
Stecker EC et al. Value-based insurance design in cardiology: Using "clinical nuance" to improve quality of care and contain costs. J Am Coll Cardiol 2012 Oct 3; [e-pub ahead of print].