ArticleHealthcare policy = Politiques de sante2009
Costs and benefits of free medications after myocardial infarction.
Article in Healthcare policy = Politiques de sante, 2009. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers, 1 of them a synthesis that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
12 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Extracorporeal Membrane Oxygenation for Cardiac Indications in Adults: A Health Technology Assessment.Ontario health technology assessment series · 2020Pooled it
- Projected Cost Savings With Optimal Medication Adherence in Patients With Cardiovascular Disease Requiring Lipid-Lowering Therapy: A Multinational Economic Evaluation Study.Journal of the American Heart Association · 2024Article
- Evaluation of Hospital-Based Acute Care Utilization by Uninsured Patients Enrolled in Free or Low-Cost Pharmacy Programs.Innovations in pharmacy · 2021Article
- Is Canadian Healthcare Affordable? A Comparative Analysis of the Canadian Healthcare System from 2004 to 2014.Healthcare policy = Politiques de sante · 2017Article
- Understanding the economic impact of intravascular ultrasound (IVUS).The European journal of health economics : HEPAC : health economics in prevention and care · 2016Article
- Estimated cost of universal public coverage of prescription drugs in Canada.CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne · 2015Article
- Economic evaluation of hormonal therapies for postmenopausal women with estrogen receptor-positive early breast cancer in Canada.Current oncology (Toronto, Ont.) · 2015Article
- Money left on the table: generic drug prices in Canada.Healthcare policy = Politiques de sante · 2013Article
- Appropriateness of cardiovascular care in elderly adult cancer survivors.Medical oncology (Northwood, London, England) · 2013Article
- The effect of cost on adherence to prescription medications in Canada.CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne · 2012Article
- Income-related inequity in initiation of evidence-based therapies among patients with acute myocardial infarction.Journal of general internal medicine · 2011Article
- Purchasing prescription drugs in Canada: hang together or hang separately.Healthcare policy = Politiques de sante · 2011Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
4 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundAlthough combination pharmacotherapy after myocardial infarction dramatically reduces morbidity and mortality, the full benefits of secondary prevention medications remain unrealized owing to medication non-adherence. Because financial barriers are a major determinant of non-adherence, we examined the costs and benefits of providing free medications to myocardial infarction patients who do not have private insurance and are ineligible for substantial public coverage.
methodsAn economic evaluation combining decision analysis and Markov modelling was conducted to compare full public coverage of secondary prevention medications with the status quo. Costs and benefits were estimated using Canadian data wherever possible. The main outcome was the incremental cost-effectiveness ratio measured in cost per quality-adjusted life-year (QALY) gained.
resultsFrom the perspective of the publicly funded healthcare system, full coverage resulted in greater quality-adjusted survival than the status quo (7.02 vs. 6.13 QALYs) but at increased cost ($20,423 vs. $17,173). The incremental cost-effectiveness ratio (ICER) for full coverage compared to the status quo was $3,663/QALY. This result was robust to a wide range of sensitivity analyses. In a secondary analysis from the perspective of government, the ICER for full coverage compared to the status quo was $12,350/QALY. In this analysis, the ICER was sensitive to changes in price elasticity, but remained below $50,000/QALY as long as the elasticity remained below -0.035.
interpretationPublic payers in Canada should consider providing secondary prevention medications to myocardial infarction patients without private insurance free of charge. Full public coverage is cost-effective compared to the status quo.
Identifiers
21037827PMC2805141What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.