Study finds higher drug co-pays discourage patients from starting...( Patients newly diagnosed with hypert...),Health

Patients newly diagnosed with hypertension, diabetes or high cholesterol are significantly more likely to delay initiating recommended drug treatment if they face higher co-payments for medications, according to a new RAND Corporation study.

The delay was significant across all conditions, but the impact was largest among patients who had not previously used prescription drugs, according to the study published in the April 27 edition of the Archives of Internal Medicine.

While several studies have established that higher drug co-payments discourage some patients from taking their medications, the new RAND Health study is the first to examine the impact higher out-of-pocket costs have on patients who are beginning drug treatment after being diagnosed with a chronic illnesses.

"Our study clearly shows that out-of-pocket costs reduce patients' willingness to start treatment for their chronic illnesses," said lead author Dr. Matthew D. Solomon, the study's lead author and an adjunct researcher at RAND, a nonprofit research organization. "It is indisputable that avoiding treatment for these conditions will lead to higher rates of heart attack and stroke."

The study included 272,474 retirees who received health coverage from their former employers from 1997 to 2002 and were covered by 31 different health plans. Researchers focused on 17,183 people from this group who were newly diagnosed with diabetes, high blood pressure or high cholesterol, examining their records to see when they began to fill prescriptions for needed medications.

For each of the conditions, patients who had higher out-of-pocket costs were less likely to start prescription drug therapy compared to other patients in the study. For example, among those newly diagnosed with high blood pressure, those starting drug treatment within a year of diagnosis dropped from 55 percent to 40 percent when their co-payment doubled. After five years, the differ
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