title: New-user persistence with antihypertensives and prescription drug cost-sharing.
abstract: This study employed a new-user design to assess predictors of persistence with antihypertensive therapy, with emphasis on prescription drug cost-sharing. This retrospective longitudinal analysis used 2001-2002 claims data from 45 large health plans. The sample consisted of 23,047 individuals with hypertension, aged 41 to 65 years and receiving new antihypertensive treatment of angiotensin-converting enzyme inhibitors, angiotensin II receptor blockers, beta-blockers, calcium channel blockers, or diuretics. Prescription drug cost-sharing was measured as generosity ratio of actual to expected copayment. Other measures included demographics, Charlson comorbidity, type of health plan, and health care spending. Multivariate models showed that generous drug coverage was associated with an 11% to 19% increase in persistence (P<.05) in 4 of 5 antihypertensive drug classes compared with less generous drug coverage, controlling for the other measures. Less generous drug coverage is a risk factor for poor persistence among most new antihypertensive users.
authors.affiliation: University of Massachusetts Medical School, Division of Geriatric Medicine, Worcester, MA 01605, USA. becky.briesacher@umassmed.edu
authors.forename: Becky A
authors.initials: BA
authors.lastname: Briesacher
authors.forename: M Rhona
authors.initials: MR
authors.lastname: Limcangco
authors.forename: Feride
authors.initials: F
authors.lastname: Frech-Tamas
mesh_terms: D000328:Adult; D000368:Aged; D000959:Antihypertensive Agents / Q000191:economics* / Q000627:therapeutic use*; D017047:Cost Sharing / Q000639:trends*; D003695:Delivery of Health Care / Q000191:economics / Q000639:trends; D016527:Drug Costs / Q000639:trends*; D005260:Female; D006801:Humans; D006973:Hypertension / Q000188:drug therapy / Q000191:economics; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D010349:Patient Compliance; D016016:Proportional Hazards Models; D012189:Retrospective Studies
chemical_list: D000959:Antihypertensive Agents