Past research has shown that people with chronic illnesses are less likely to take medication if they are faced with higher drug co-pays. Now, for the first time, a study has been conducted to examine the impact that higher out-of-pocket costs, specifically higher drug co-pays, have on patients newly diagnosed with a chronic illness and just beginning drug treatment. As the new RAND Corporation Health Study found, newly diagnosed patients with such chronic conditions as hypertension, diabetes and high cholesterol are "significantly more likely to delay initiating recommended drug therapy if they face higher co-payments for medications." The study also found that the delay was most pronounced in patients who had not previously used prescription drugs.

To conduct the study, investigators from RAND, a non-profit research organization, reviewed the health records of 17,183 people who had received health coverage from their former employees between 1997 and 2002. Participants had indicated that they were covered by 31 different health plans. The researchers looked specifically for information on when the patients had begun to fill their prescriptions.

The results offered compelling evidence. For example, patients who started drug therapy within a year of being diagnosed with high blood pressure dropped from 55 percent to 40 percent - and from 40 to 31 percent for those patients newly diagnosed with high cholesterol - when out-of-pocket costs were doubled. After five years, the percentage of patients with high blood pressure dropped from 82 percent to 66 percent after co-pays doubled - and from 64 percent to 54 percent in patients with high cholesterol. The results for people with diabetes were similar. The study also showed that patients who had no experience with medications were even less likely to begin recommended drug treatment.

Lead author Dr. Matthew D. Solomon, an adjunct researcher at RAND, believes that the study has implications for those policymakers and insurance officials who may be interested in creating policies that enhance medication compliance. It also helps shed light on the types of patients who are more likely to ignore the recommendations of their physicians. "Our study clearly shows that out-of-pocket costs reduce patients' willingness to start treatment for their chronic illnesses," Dr. Solomon says. "Along with behavioral and lifestyle modification, prescription drug therapy is the cornerstone of management for these diseases. If left untreated, each of these conditions will increase a person's risk for having a potentially fatal cardiovascular event, such as a heart attack or stroke." And he adds, "Epidemiologic studies tell us that we do a terrible job of treating patients with these conditions. Now we know one reason why."

News Release: Study finds higher drug co-pays discourage patients from starting treatment   www.eurekalert.org    April 28, 2009