Conference Coverage

VIDEO: Patient vouchers prompt physicians to prescribe top antiplatelet drugs

 

Key clinical point: Physicians were more likely to prescribe ticagrelor after an MI when patients received vouchers.

Major finding: Patients with vouchers received prescriptions for ticagrelor significantly more than clopidogrel (60% vs. 36%).

Study details: The data come from a randomized trial of 301 hospitals in the United States and included 11,001 MI patients.

Disclosures: ARTEMIS was funded by AstraZeneca. Dr. Wang disclosed relationships with companies including Gilead Sciences, Merck, and Sanofi Pasteur. Dr. Beavers had no financial conflicts to disclose.

Source: Wang T. ACC 2018.


 

REPORTING FROM ACC 18

– Patients who received vouchers to cover copayments were more likely to receive prescriptions for more effective antiplatelet medication, according to data from a multicenter, randomized trial.

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“We know that guidelines are very clear; we need to treat patients with antiplatelet therapy for 12 months,” and that the most potent drug, ticagrelor, should be used, Tracy Wang, MD, of Duke University, Durham, N.C., said in a video interview at the annual meeting of the American College of Cardiology. However, in the United States, clopidogrel, though less effective, is prescribed much more often, and many patients discontinue their P2Y12 inhibitor therapy within the first year because of cost, she added.

“We hypothesized that, by reducing the out of pocket costs, treatment would be more evidence driven, rather than driven by what patients could afford,” she said.

The Affordability and Real-World Antiplatelet Treatment Effectiveness After Myocardial Infarction Study (ARTEMIS) included 11,001 MI patients at 301 hospitals across the United States. Patients in the treatment hospital group received a voucher to use at a pharmacy or through a mail-order pharmacy to reduce out of pocket costs. Randomization occurred at the hospital level, and hospital characteristics were similar between the groups.

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