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kdiwavvou:
πολλοί  επευφυμούν το Σκανδιναβικό μοντέλο ....
αν δει κανείς όλες αυτές τις μελέτες και τα trials [ άντε να πάρεις άδεια για τα προσωπικά δεδομένα και τις πειραματικές παρεμβάσεις εν Ελλάδει  [ γελάτε έ ; γελάτε ! ] ], μπορεί να ισχυριστεί πως οι αμερικανικές φαρμaκοβιομηχανίες κάνανε καλά τη δουλειά τους και τη σύμπραξη συμφωνιών / συμβολαίων την προηγούμενη δεκαετία


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What If MI Patients Got Their Follow-Up Meds for Free?

In a cluster-randomized study, improvement in adherence — and in some outcomes — was significant but small.

Prescription of evidence-based medications after acute myocardial infarction (AMI) has increased substantially over the past decade. However, prescription does not ensure benefit; patients must obtain and take the drugs. In this study, sponsored by a large U.S. commercial insurer, investigators assessed full prescription coverage for evidence-based drug therapy following AMI in 5855 patients (mean age, 54; 75% men). Participants were randomized at the level of the health-plan sponsor to either full or usual coverage for angiotensin-converting–enzyme (ACE) inhibitors, angiotensin-receptor blockers (ARBs), beta-blockers, and statins.

Average monthly co-payments in the usual-coverage group were $13.35 for ACE inhibitors or ARBs, $12.83 for beta-blockers, and $24.92 for statins. At a median follow-up of 394 days, the rate of the primary outcome — first major vascular event or revascularization — was 17.6% per 100 person-years with full coverage and 18.8% per 100 person-years with usual coverage (P=0.21). However, the rate of total major vascular events or revascularization was significantly lower in the full-coverage group than in the usual-coverage group (21.5% vs. 23.3%; P=0.03). Adherence rates for specific medication types ranged from 36% to 49% in the usual-coverage group and were significantly higher by 4% to 6% in the full-coverage group; adherence to all three medications was 44% in the full-coverage group and 39% in the usual-coverage group. Patient costs for drugs and other services during follow-up were significantly lower with full coverage than with usual coverage (by almost $500, or 26%); total spending did not differ significantly between the groups ($66,008 and $71,778 with full and usual coverage, respectively).

Comment: Despite this study's failure to demonstrate benefit with respect to the primary endpoint, full secondary-prevention prescription coverage after MI seems compelling: it increases adherence, reduces patient costs, does not increase overall costs, and may improve some outcomes. These findings should convince payers to rethink the structure of their benefit plans. Also notable are the atrocious adherence rates among insured patients, even with no out-of-pocket costs. As editorialists note, much more than innovative insurance design is required to get patients to take their pills.

— Frederick A. Masoudi, MD, MSPH, FACC, FAHA

Published in Journal Watch Cardiology November 14, 2011
Citation(s):

Choudhry NK et al. for the Post-Myocardial Infarction Free Rx Event and Economic Evaluation (MI FREEE) Trial. Full coverage for preventive medications after myocardial infarction. N Engl J Med 2011 Nov 14; [e-pub ahead of print]. (Δεν είναι ορατοί οι σύνδεσμοι (links). Εγγραφή ή Είσοδος)

Goldman L and Epstein AM. Improving adherence — Money isn't the only thing. N Engl J Med 2011 Nov 14; [e-pub ahead of print]. (Δεν είναι ορατοί οι σύνδεσμοι (links). Εγγραφή ή Είσοδος)



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φαντάσου λέει να βγεί κοινοποίηση βάσει του Ν/τάδε  ότι :


από την τάδε του μηνός , η συγκεκριμένη -αρτάνη,  η συγκεκριμένη -απρίλη,  η συγκεκριμένη -λόλη και  η συγκεκριμένη -ατίνη θα χορηγούνται δωρεάν στους πληρούντες τις προοϋποθέσεις  τάδε

με επισήμανση πως εάν ο ασθενής ή / και ο ιατρός επιθυμούν  αγωγή με λοιπή ουσία τότε θα συμμετέχει ο χρήστης υπηρεσιών υγείας με 10% ή με 25% ή ακόμη και με 100%

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δώσε και μένα  Βάνα [ μπάρμπα ]

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