Adherence to Statin Therapy Under Drug Cost Sharing in Patients With and Without Acute Myocardial Infarction

• DOI: 10.1161/circulationaha.106.665992
• Publication Date: 2007-04-10T00:50:34Z
• Authors: Sebastian Schneew...; Amanda R. Patrick; Malcolm Maclure; Colin R. Dormuth; Robert J. Glynn
• Keywords: Pharmacotherapy

As medication spending grows, Medicare Part D will need to adapt its coverage policies according emerging evidence from a variety of insurance policies. We sought evaluate the consequences copayment and coinsurance on initiation statin therapy after acute myocardial infarction adherence in initiators using natural experiment all British Columbia residents aged 66 years older.Three consecutive cohorts that included patients who began during full drug (2001), with $10 or $25 copay (2002), 25% benefit (2003-2004) were followed up linked healthcare utilization data (n=51,561). Follow-up was 9 months each policy change. Adherence defined as > = 80% days covered. Relative full-coverage policies, new significantly reduced, 55.8% 50.5%, under fixed (-5.4% points; 95% CI, -6.4% -4.4%) subsequent -6.3% -4.4%). An uninterrupted increase proportion initiating an (1.7% points per quarter) observed over study period, similar Pennsylvania control population coverage. Sudden changes out-of-pocket spending, Medicare's "doughnut hole," almost doubled risk stopping statins (adjusted odds ratio, 1.94, 1.82 2.08).Fixed patient have negative effects lipid-lowering but not their infarction.