Co-Payments Cut Statin Use

One cardiologist thinks that financial barriers to drugs can increase the risk for serious medical problems.

"The debate about insurance should be as much about coverage as merely the insurance itself," said Dr. Harlan M. Krumholz, a professor of medicine at Yale University School of Medicine.

"The nature of the coverage and the burden it imposes can have important effects on the ability of patients to adhere to recommendations and ultimately affect their likelihood of avoiding future adverse events," he said.

Another expert said this study is more evidence of the need to reform the health insurance system in the United States.

"This study comes on the heels of another recent study showing that people with a heart attack who report financial barriers to care have worse health outcomes," said Carol Pryor, a senior policy analyst at The Access Project, a nonprofit group that looks at issues surrounding access to health care.

Increasing co-insurance and co-payments for proven, effective care reduces access to care for patients and increases costs for the health-care system in the long run, Pryor said. "These findings should be a wake-up call to U.S. policymakers who think that the best way to reduce health-care costs is to shift more and more of them on to consumers."

Gail Shearer, director of Health Policy Analysis at Consumers Union, said part of the solution to the cost of statins is to get more people to use generic versions of the drugs.

"This study reinforces the need to educate consumers about the relatively affordable, safe and effective statins options that exist in the marketplace," she said. "Higher out-of-pocket costs affect compliance. And generics offer millions of people in need of statins substantially lower out-of-pocket costs."

More information

For more on statins, visit the American Heart Association.

SOURCES: Sebastian Schneeweiss, M.D., Sc.D., associate professor of medicine and epidemiology, Harvard Medical School and Harvard School of Public Health, Boston; Carol Pryor, senior policy analyst, The Access Project, Boston; Gail Shearer, director, Health Policy Analysis, Consumers Union, Washington, D.C.; Harlan M. Krumholz, M.D., professor of medicine, Yale University School of Medicine, New Haven, Conn.; April 24, 2007,Circulation