Randomised controlled trial
Eliminating Medication Copayments for Low-Income Older Adults at High Cardiovascular Risk: A Randomized Controlled Trial
- Randomised controlled trial
- 2×2 factorial
Authors' conclusion
In low-income adults at high cardiovascular risk, eliminating copayments (average, $35/mo) did not improve clinical outcomes or reduce health care costs, despite a modest improvement in adherence to medications.
Study context
- Population
- Low-income older adults at high CV risk, Alberta, Canadamedian follow-up 36 months
- Participants
- 4,761 adults
- Comparison
- Copayment elimination vs usual copayment
- Primary endpoint
- Composite of:
- Death
- MI
- Stroke
- Coronary revascularization
- CV-related hospitalizations
- Follow-up
- 3-year follow-up
Primary result
As reported in the abstract
Incidence rate ratio
0.84
95% CI 0.66–1.07
P = 0.162
Events by treatment group
Copayment elimination
521
events
Usual copayment
533
events
Copayment elimination vs Usual copayment
IRR 0.84 (95% CI 0.66–1.07); P = 0.162
Secondary outcomes
| Outcome | Copayment elimination | Usual copayment | mean difference (95% CI) | P value | |
|---|---|---|---|---|---|
| Statin adherence (proportion adherent) | 0.72 | 0.69 | 0.03 (0.006–0.06) | P = 0.016 | |
| −0.0500.050.1Difference (linear scale) |
Primary outcome components
- Nonfatal MI, nonfatal stroke and CV death: IRR (95% CI); no difference between groups
- 0.97 (0.67-1.39)
- Death: IRR (95% CI); no difference between groups
- 0.94 (0.80 to 1.11)
- CV-related hospitalizations: IRR (95% CI); no difference between groups
- 0.78 (0.57 to 1.06)
Quality of life (EuroQol 5-dimension index score)
- No significant between-group changes over time: mean difference
- 0.012 (−0.006 to 0.030), P=0.19 (95% CI)
Overall adjusted health care costs
- Did not differ (95% CI)
- $3575 (−605 to 7168), P=0.098
Original publication
Eliminating Medication Copayments for Low-Income Older Adults at High Cardiovascular Risk: A Randomized Controlled Trial. Circulation. Published 5 March 2023. doi:10.1161/circulationaha.123.064188
Summarised from the published abstract; every number is checked against it