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Patients not sticking to cholesterol drugs -- and the higher their co-pay, the lower their use

ANN ARBOR, Mich. -- Tens of millions of Americans take cholesterol-lowering drugs every day to keep their blood vessels clear and reduce their risk of heart attacks and other cardiovascular problems.

Or do they?

A new study finds that nearly half of patients who have a prescription for any of the cholesterol-fighting drugs called statins fail to fill their prescription often enough -- or stop filling it altogether, even though statins give the most benefit if used long-term.

Not surprisingly, patients' out-of-pocket costs for these drugs are a contributing factor. Patients whose insurance plans make them pay more than $20 for each month's supply are three times more likely to fall behind on their prescription, and four times more likely to stop taking the drug altogether, than those whose co-pay is under $10, the new study finds.

In fact, researchers from the University of Michigan Health System and Cleveland Clinic report that almost half of those who were prescribed a statin didn't adhere to the treatment, and about half of first-time users discontinued taking the drug within four years. The team's paper, based on insurance and medical records for 4,802 patients, is in the June issue of the Journal of General Internal Medicine.

The low rate of adherence, and the impact of co-pays, was nearly equal for patients who just had high cholesterol and for those patients who needed statins even more, because they had already survived a heart attack, been diagnosed with diabetes or clogged blood vessels, or had surgery or angioplasty to open blocked arteries.

"This was a big surprise that the two groups were almost identical," says first author Jeffrey Ellis, Pharm.D., M.S., a Cleveland Clinic researcher who led the study while he was a fellow at the UMHS Department of Pharmacy Services. "We thought we'd definitely see less discontinuation and better compliance in the sicker patients because they've been
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Contact: Kara Gavin
kegavin@umich.edu
734-764-2220
University of Michigan Health System
8-Jun-2004


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