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More Heart Attack Patients Take Meds When They Are Free
Date:11/14/2011

ed medication adherence and the number of major cardiovascular events, including readmission for fatal or nonfatal heart attack, unstable angina, heart failure or stroke and procedures to open a blocked artery (revascularization).

They also looked at the patients' out-of-pocket costs plus their overall health care expenses.

Overall, the patients' adherence rate ranged from 36 percent to 49 percent in the usual coverage group. Eliminating co-pays improved adherence, but did not reduce the number of cardiovascular events or revascularization procedures, the researchers found.

However, when they took into account all events, not only first events, rates were cut by 11 percent in the patients with no co-pays.

And when revascularizations were discounted, rates of events dropped 14 percent.

Moreover, the rates of rehospitalization for another heart attack, angina, heart failure and stroke also went down, they said.

Total health care spending was not increased, and patients saw a relative reduction in out-of-pocket costs of 26 percent, the researchers noted.

The reasons why patients don't take their drugs vary, Choudhry said. These include cost, side effects, the burden of taking a lot of pills, forgetfulness and knowledge about the drugs, he said.

"Ultimately, we need to tackle each of these," said Choudhry.

Patients with chronic disease who do not take their medications cost the heath care system hundreds of billions of dollars each year, Choudhry said. "Non-adherence is a public health problem," he added.

Dr. Gregg C. Fonarow, a professor of cardiology at the University of California, Los Angeles, and a spokesman for the American Heart Association, said that after discharge many patients fail to fill their prescriptions or discontinue taking needed drugs, and the consequences can be fatal.

"This simple strategy of enhancing prescription coverage, particularly if coupled with other efforts to improve pat
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