1. Does the Effectiveness of a Medicine Copay Voucher Vary by Baseline Medication Out‐Of‐Pocket Expenses? Insights From ARTEMIS
- Author
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Rymer, Jennifer A, Kaltenbach, Lisa A, Peterson, Eric D, Cohen, David J, Fonarow, Gregg C, Choudhry, Niteesh K, Henry, Timothy D, Cannon, Christopher P, and Wang, Tracy Y
- Subjects
Biomedical and Clinical Sciences ,Clinical Sciences ,Cost Effectiveness Research ,Heart Disease - Coronary Heart Disease ,Cardiovascular ,Heart Disease ,Good Health and Well Being ,Humans ,Health Expenditures ,Medication Adherence ,Myocardial Infarction ,Purinergic P2Y Receptor Antagonists ,Treatment Outcome ,copay ,myocardial infarction ,persistence ,voucher ,Cardiorespiratory Medicine and Haematology ,Cardiovascular medicine and haematology - Abstract
Background Persistence to P2Y12 inhibitors after myocardial infarction (MI) remains low. Out-of-pocket cost is cited as a factor affecting medication compliance. We examined whether a copayment intervention affected 1-year persistence to P2Y12 inhibitors and clinical outcomes. Methods and Results In an analysis of ARTEMIS (Affordability and Real-World Antiplatelet Treatment Effectiveness After Myocardial Infarction Study), patients with MI discharged on a P2Y12 inhibitor were stratified by baseline out-of-pocket medication burden: low ($0-$49 per month), intermediate ($50-$149 per month), and high (≥$150 per month). The impact of the voucher intervention on 1-year P2Y12 inhibitor persistence was examined using a logistic regression model with generalized estimating equations. We assessed the rates of major adverse cardiovascular events among the groups using a Kaplan-Meier estimator. Among 7351 MI-treated patients at 282 hospitals, 54.2% patients were in the low copay group, 32.0% in the middle copay group, and 13.8% in the high copay group. Patients in higher copay groups were more likely to have a history of prior MI, heart failure, and diabetes compared with the low copay group (all P
- Published
- 2022