Eliminating copays helps reduce disparities in cardiovascular care

Eliminating drug plan copays for specific, targeted groups of patients is an easy administrative fix employers can implement to help reduce disparities in care, says the co-author of a study on reducing ethnic disparities in cardiovascular care.

A new study by researchers at CVS Caremark, Aetna and Brigham and Women’s Hospital finds that eliminating copays for preventive medications prescribed for patients after they’ve had a heart attack  can significantly improve medication adherence and health outcomes for non-white patients.

“We know there are important disparities in care, particularly in the management of chronic disease, and some of that is likely mediated by how patients adhere to their medications,” says William H. Shrank, M.D., senior vice president and chief scientific officer of CVS Caremark, and a co-author of the study. “A lot of people have described disparities in care, but very few interventions have been delivered that actually reduce the disparities.”

Also see: Expanding HDHP coverage of preventive services could save millions

Racial and ethnic disparities in cardiovascular care have been widely documented and persist despite overall improvements in cardiovascular mortality and risk factor control. Past research from CVS Caremark and Brigham and Women’s Hospital, published last year in The American Heart Journal, found that non-white patients had 50% greater odds of medication non-adherence to statin medications compared to white patients.

In this latest analysis, published in the May issue of Health Affairs, the researchers looked at whether providing full coverage for common medications prescribed after a heart attack had different effects based on race and ethnicity. More than 2,300 individuals were included in the analysis, of which 22.2% self-identified as being of non-white race/ethnicity.

The study found that providing full drug coverage reduced total health care spending by 70% among patients who identified themselves as being non-white.

“We see a meaningful improvement in clinical outcomes in the ethnic minority patients and it speaks to the fact that using this kind of [value-based] benefit design can reduce those disparities,” says Shrank, adding that eliminating copays for targeted groups of patients isn’t an overly burdensome process for plan sponsors. “This is a very simple, easy-to-apply intervention. You don’t have to hire people to go visit patients in their homes. It’s an easy administrative edit that just eliminates cost-sharing for specific, targeted patients.”