ArticleHeart (British Cardiac Society)2017
Effect of cost sharing on adherence to evidence-based medications in patients with acute coronary syndrome.
Article in Heart (British Cardiac Society), 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 23 papers.
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Who cites it
23 citing papers in PubMed.
- The cost-effectiveness of value-based insurance design initiatives in managing cardiometabolic diseases: a systematic review.The European journal of health economics : HEPAC : health economics in prevention and care · 2026Article
- Predicting risk of treatment non-adherence in patients receiving intense light therapy: development and evaluation of a new predictive nomogram.Lasers in medical science · 2025Article
- Newly Started Versus Previously Treated Statin Patients: A Retrospective Cohort Study Comparing Adherence and Persistence with Reference to Cardiovascular Prevention.Pharmaceuticals (Basel, Switzerland) · 2025Article
- Adherence to antiretroviral and cancer chemotherapy, and associated factors among patients with HIV-cancer co-morbidity at the Uganda Cancer Institute: a cross sectional study.BMC public health · 2023Article
- Statin Prescription Patterns Among Elderly Patients with Type 2 Diabetes: A Cross-Sectional Study in Lebanon.Drugs - real world outcomes · 2023Article
- Medication economic burden of antidepressant non-adherence in Spain.Frontiers in pharmacology · 2023Article
- Prior Cardiovascular Treatments-A Key Characteristic in Determining Medication Adherence After an Acute Myocardial Infarction.Frontiers in pharmacology · 2022Article
- Effects of the Full Coverage Policy of Essential Medicines on Inequality in Medication Adherence: A Longitudinal Study in Taizhou, China.Frontiers in pharmacology · 2022Article
- Effect of the full coverage policy of essential medicines on medication adherence: A quasi-experimental study in Taizhou, China.Frontiers in public health · 2022Article
- Factors Associated with Free Medicine Use in Patients with Hypertension and Diabetes: A 4-Year Longitudinal Study on Full Coverage Policy for Essential Medicines in Taizhou, China.International journal of environmental research and public health · 2021Article
- Health Outcomes and Primary Adherence to Secondary Prevention Treatment after St-Elevation Myocardial Infarction: a Spanish Cohort Study.Journal of cardiovascular translational research · 2021Observational
- Who Suffers From Pharmaceutical Poverty and What Are Their Needs? Evidence From a Spanish Region.Frontiers in pharmacology · 2021Article
- Assessment of Variation in State Regulation of Generic Drug and Interchangeable Biologic Substitutions.JAMA internal medicine · 2021Article
- The effect of pharmaceutical co-payment increase on the use of social assistance-A natural experiment study.PloS one · 2021Article
- Impact of reimbursement rates on the length of stay in tertiary public hospitals: a retrospective cohort study in Shenzhen, China.BMJ open · 2020Article
- Data Resource Profile: The Valencia Health System Integrated Database (VID).International journal of epidemiology · 2020Article
- Prescribing and medical non-adherence after myocardial infarction: qualitative interviews with general practitioners in Germany.BMC family practice · 2020Article
- Financial Catastrophism Inherent with Out-of-Pocket Payments in Long Term Care for Households: A Latent Impoverishment.International journal of environmental research and public health · 2020Article
- Impact of Drug Safety Warnings and Cost-Sharing Policies on Osteoporosis Drug Utilization in Spain: A Major Reduction But With the Persistence of Over and Underuse. Data From the ESOSVAL Cohort From 2009 to 2015.Frontiers in pharmacology · 2019Article
- Improving adherence to high-value medications through prescription cost-sharing policies.BMJ quality & safety · 2018Article
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9 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesCost-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.
methodsPopulation-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.
resultsCost-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.
conclusionsCoinsurance 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.
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