Reduced copayment policy has benefits all round

Oct 18 2012

By Piriya Mahendra, medwireNews Reporter

Reducing patients' copayments for statins and clopidogrel could increase their adherence without adding financial burden to the healthcare system, researchers say.

Niteesh Choudhry (Brigham and Women's Hospital, Boston, Massachusetts, USA) and team found that patients with diabetes and vascular disease who were on a corporate health insurance plan that provided copayment reductions for statins and clopidogrel had an increased medication adherence and a reduced risk for physician visits, hospitalizations, and emergency department (ED) admissions.

They also spent less out-of-pocket on other drugs and medical services, and the reduced copayment policy was cost-neutral with regard to overall health spending.

Indeed, the reduced copayment policy resulted in an increase in the monthly rate of statin prescription filling by 7.1 percentage points, and a corresponding increase in clopidogrel prescription filling by 5.9 percentage points.

Patients with reduced copayments for statins had a 20% reduced risk for physician visits and a 10% reduced risk for hospitalizations and ED admissions, while those with reduced copayments for clopidogrel had a 13% and 11% reduced risk for these respective outcomes.

However, reduced copayments were not associated with a significant reduction in major coronary events.

Patients with reduced copayments for statins also decreased their out-of-pocket spending for other drugs and medical services by 21%, while those with reduced copayments for clopidogrel experienced a reduction of 26%. Overall, combined insurer and patient spending for drugs and medical services was not significantly changed.

As reported in the Journal of the American College of Cardiology, the study included 2830 patients who were eligible for copayment reductions and 49,801 controls.

Choudhry et al conclude that the findings "suggest overall cost neutrality and beneficial effects for resource use and thus support the reduction of evidence-based medication copayments for a wide range of cardiovascular drugs and patient risk groups."

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