Identificador persistente para citar o vincular este elemento: http://hdl.handle.net/10553/20868
Título: Effect of cost sharing on adherence to evidence based medications in patients with acute coronary syndrome
Autores/as: González López-Valcárcel, Beatriz 
Librero, Julian
García Sempere, A.
Peña, Luz Marina
Bauer, S.
Puig Junoy,Jaume 
Oliva Moreno, J.
Peiro, Salvador
Sanfelix-Gimeno, Gabriel
Clasificación UNESCO: 531207 Sanidad
Palabras clave: Coste farmacéutico
España
Fecha de publicación: 2017
Publicación seriada: Heart 
Resumen: Objectives Cost-sharing scheme for pharmaceuticals in Spain changed in July 2012. Our aim was to assess the impact of this change on adherence to essential medication in patients with acute coronary syndrome (ACS) in the region of Valencia. Methods Population-based retrospective cohort of 10 563 patients discharged alive after an ACS in 2009–2011. We examined a control group (low-income working population) that did not change their coinsurance status, and two intervention groups: pensioners who moved from full coverage to 10% coinsurance and middle-income to high-income working population, for whom coinsurance rose from 40% to 50% or 60%. Weekly adherence rates measured from the date of the first prescription. Days with available medication were estimated by linking prescribed and filled medications during the follow-up period. Results Cost-sharing change made no significant differences in adherence between intervention and control groups for essential medications with low price and low patient maximum coinsurance, such as antiplatelet and beta-blockers. For costlier ACE inhibitor or an angiotensin II receptor blocker (ACEI/ARB) and statins, it had an immediate effect in the proportion of adherence in the pensioner group as compared with the control group (6.8% and 8.3% decrease of adherence, respectively, p<0.01 for both). Adherence to statins decreased for the middle-income to high-income group as compared with the control group (7.8% increase of non-adherence, p<0.01). These effects seemed temporary. Conclusions Coinsurance changes may lead to decreased adherence to proven, effective therapies, especially for higher priced agents with higher patient cost share. Consideration should be given to fully exempt high-risk patients from drug cost sharing.
URI: http://hdl.handle.net/10553/20868
ISSN: 1355-6037
DOI: 10.1136/heartjnl-2016-310610
Fuente: Hear t[ISSN 1355-6037],v. 103 (14), p. 1082-1088, (Julio 2017)
Derechos: by-nc-nd
Colección:Artículos
miniatura
Adobe PDF (460,2 kB)
Vista completa

Google ScholarTM

Verifica

Altmetric


Comparte



Exporta metadatos



Los elementos en ULPGC accedaCRIS están protegidos por derechos de autor con todos los derechos reservados, a menos que se indique lo contrario.