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Vets Often Forgo Medication When Co-Pays Rise
Date:1/12/2009

ay amount was increased again in 2006, to $8, Doshi said. And several presidential budget proposals, including the 2008 plan, included a co-payment increase to $15 for a 30-day supply, she said.

"While these proposals were not incorporated into legislation, it is likely they might be in the future," Doshi said. "Policymakers must consider the findings and implication of studies such as ours in future policy reform initiatives."

Co-pay amounts are the same whether a drug is a generic or a brand-name medication, she said.

"This is particularly relevant in the case of cholesterol-lowering medications such as statins, wherein two brand-name statins have become available as generics since 2006 and are available at significantly lower prices to the Department of Veterans Affairs," Doshi said "Presumably, the VA could charge veterans lower co-payments for such medications and thereby facilitate higher adherence with drugs from such essential medication classes."

For the study, Doshi and her fellow researchers collected data on 5,604 veterans taking cholesterol-lowering drugs prescribed by the Philadelphia VA Medical Center from November 1999 to April 2004.

They compared veterans who had to make co-payments with similar veterans who were exempt from prescription drug co-payments, and they looked at adherence to cholesterol-lowering drugs in the two years before and the two years after the co-pay increase.

Besides the overall drop in adherence rates, the researchers detected a decline among a particular group of veterans.

"Of even greater concern was our finding that a similar adverse effect of the co-payment increase was observed in groups at higher risk for coronary heart disease who were using these medications for either primary or secondary prevention," Doshi said.

Because of this, she said, "policymakers need to pay particular attention to the fact that a 'one-size-fits-all' approach t
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