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Co-Payment Increases Result in Gaps in Veterans' Prescription Usage
Date:1/14/2009

n 80 percent or more of the time were considered adherent.

Researchers found:

  • The number of patients who had medications available for more than 80 percent of the time declined by more than 19 percent in both the all co-payment group and the some co-payment group. In comparison, veterans exempt from co-payments, used as controls in the study, had a decline of 12 percent.
  • The odds of having a continuous gap without medications for more than 90 days was three times higher among patients in the all co-payment group and twice as high in patients in the some co-payment group when compared to the exempt group.

"The increase in co-payments adversely impacted lipid-lowering medication adherence among veterans," said Jalpa A. Doshi, Ph.D., lead author of the study and research assistant professor of medicine at the University of Pennsylvania School of Medicine. "Of even greater concern is our finding on the similar adverse effect of the co-payment increase in veterans who are at higher risk for coronary artery disease taking the medications for primary or secondary prevention."

Statins and other cholesterol-lowering drugs have been shown to reduce the risk of future coronary events and cardiovascular mortality in patients at high risk, Doshi said.

"It is concerning to see that the increase in co-payments adversely affected the use of these usually long-term medications, especially since the prevalence of heart disease is higher in the VA population than in the general population," Doshi said. "These weren't just short gaps interspersed between lipid-lowering medication refills, but continuous gaps for 90 days or more."

The study did not look at the possible increase in use of medical care due to the lack of cholesterol-lowering drugs. Other studies have shown that not taking medications for chronic diseases in
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SOURCE American Heart Association
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