High cost of stroke medication putting patients at risk
Researchers at University of Michigan Health Systems say young uninsured and Medicare part D recipients cannot afford stroke medications, putting them at higher risk for recurring cardiovascular events.
The findings, presented at the American Stroke Association's International Stroke Conference 2011 is the result of a study exploring cost related medication adherence among stroke patients after institution of Medicare part D prescription drug coverage in 2006.
The research showed that even with Medicare part D drug coverage, many disadvantaged stroke survivors cannot afford the high cost of medications that come with high co-payments and are not available in generic form from drug company patents on the medications. The study found in 2009, 11 percent of 150,000 stroke patients were unable to afford preventive medications and didn't take them as a result.
Among those, forty two percent had Medicare part D but non adherence to stroke medications was double that of those who did not have prescription drug coverage - 12 percent, compared to 6 percent.
The reason was not explained by the investigators,but it may be that drug companies are more willing to provide assistance to patients who do not have drug coverage. An example is the manufacturer of Plavix, a costly medication given to patients to prevent stroke recurrence who generously provide free medication through their patient assistance program, but will not give help to anyone with drug coverage.
Deborah A. Levine, M.D., M.P.H., the study's lead author and an assistant professor of medicine at the University of Michigan in Ann Arbor says, "Federal programs to reduce cost-related non-adherence to medication may not be working as intended, and a resulting large number of stroke survivors are at risk for subsequent stroke events, adding, "Medicare Part D has not resolved the problem of cost-related non-adherence to medication among Medicare beneficiaries with stroke."
She suggests physicians ask stroke patients if they can afford their medications. In the study, younger patients age 45 to 54 were found to have higher rates of non adherence to medications that was not changed among older patients after Medicare part D became available.
Inability to afford the medications prescribed rose to 60 percent from 2006 to 2009, compared to 39 percent from 1998 to 2002. The researchers note the findings should be interpreted with caution because the study is based on self-reporting, not taking into consideration of timing of stroke, personal attitudes about taking medications and severity of the event.
The findings that uninsured and Medicare part D stroke patients cannot afford medications are important for clinicians who can assist by screening for ability to adhere to prescriptions needed to prevent recurrent cardiovascular events.