Academic and industry researchers have found heart attack patients whose insurance fully covered their medications had lower rates of rehospitalization for heart attack or heart failure compared to patients who had prescription co-pays. The team from Brigham and Women’s Hospital and Harvard Medical School in Boston, Aetna Insurance in Hartford, Connecticut, and CVS Caremark in Woonsocket, Rhode Island presented their findings at the American Heart Association’s Scientific Sessions 2011 in Orlando, and published online in the New England Journal of Medicine.
The team studied 5,855 patients discharged from hospitals after a heart attack. Of those patients, 2,845 paid no extra charges for their cholesterol-lowering and other medications, while 3,010 patients who had insurance co-pays.
The absence or presence of co-pays made an immediate difference in the patients’ adherence to their medications: patients with full insurance coverage for their medications — those who paid nothing extra — were more four to six percent more likely to take their drugs than the patients with co-pays.
In overall incidence of subsequent major cardiac events — heart attack, angina, stroke, or heart failure — the researchers found no statistical difference between the two types of coverage: 17.6 percent of those with full coverage had a major cardiac event, compared to 18.8 percent of those with co-pays.
But looking a specific types of major events, some differences emerge. When removing revascularization procedures — those that restore adequate blood flow, such as coronary bypass — the researchers report patients with full coverage had 14 percent fewer cases of major cardiac events, such as heart attack or heart failure. The team found little difference in revascularization rates between full coverage and co-pay patients.
The degree of coverage for medications had further economic effects as well. The researchers report that patients with full medication coverage saved 26 percent on their overall out-of-pocket health care costs. Because of improved health, the full-coverage patients paid fewer copayments for doctor’s visits in addition to the savings from no drug co-pays.
Insurance company costs overall, say the researchers, did not rise as a result of full medication coverage. While insurers spent more on medications, they spent less on treating subsequent heart problems.
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