title: Full coverage for hypertension drugs in rural communities in China.
abstract: The control rate for hypertension is unacceptably low worldwide, and poor adherence to medication is a primary reason.
  
  
  
  To evaluate the impact of full coverage for hypertension drugs on adherence to medication, medical costs, and hypertension control in Shandong Province, China.
  
  
  
  In November 2009, we interviewed 110 hypertensive patients who had been participating in a free medication program since May 2008 and 241 hypertensive patients who were not participating. We used a 1:1 propensity-score matching technique to obtain matched samples of 102 program participants (intervention) and 102 nonparticipants (control). We used univariate analysis to compare patient drug-taking behaviors, medical costs, and hypertension control between the 2 groups.
  
  
  
  All intervention patients took > 1 drugs for hypertension control and 93% of them took > 3 such drugs, 15 control patients (15%) did not take any, and only 39% took 3 or more (P < .001). Three-fourths (75%) of the intervention patients took the prescribed drugs regularly, whereas 66% of the control group (P = .034) did so. Participation in the program was associated with lower annual out-of-pocket medical costs both overall and for outpatient services (P < .001 for both).
  
  
  
  Low-income rural residents in China receiving free drugs had enhanced medication adherence and reduced total medical costs. Providing hypertension drugs at no charge may be a promising strategy for preventing costly cardiovascular events associated with hypertension in China and other parts of the world with growing rates of cardiovascular disease.
authors: School of Insurance and Economics, University of International Business and Economics, Chaoyang, Beijing, China.
authors: Baorong
authors: B
authors: Yu
authors: Xiaojuan
authors: X
authors: Zhang
authors: Guijing
authors: G
authors: Wang
mesh_terms: D000959:Antihypertensive Agents / Q000191:economics / Q000627:therapeutic use*; D002681:China / Q000453:epidemiology; D016527:Drug Costs; D005380:Financing, Government; D005382:Financing, Personal; D006801:Humans; D006973:Hypertension / Q000188:drug therapy* / Q000191:economics / Q000523:psychology; D055118:Medication Adherence / Q000523:psychology; D011203:Poverty; D057216:Propensity Score; D012424:Rural Population / Q000706:statistics & numerical data; D016903:Drug Monitoring
chemical_list: D000959:Antihypertensive Agents
references: Am J Cardiol. 2007 Feb 1;99(3):393-8
references: 17261405
references: Med Care. 2010 May;48(5):418-25
references: 20393367
references: Stat Med. 1998 Oct 15;17(19):2265-81
references: 9802183
references: Am J Manag Care. 2009 Jul;15(7):450-6
references: 19589012
references: Lancet. 1997 May 17;349(9063):1436-42
references: 9164317
references: J Hypertens. 2011 Jul;29(7):1303-10
references: 21558952
references: Hypertension. 2002 Dec;40(6):920-7
references: 12468580
references: Int J Clin Pract. 2008 Feb;62(2):338-51
references: 18199282
references: J Hypertens. 2003 Apr;21(4):707-16
references: 12658016
references: J Hypertens. 2010 Mar;28(3):432-8
references: 20087215
references: Am J Hypertens. 2010 Mar;23(3):275-81
references: 20010701
references: N Engl J Med. 2005 Sep 15;353(11):1124-34
references: 16162883
references: Lancet. 2005 Jan 15-21;365(9455):217-23
references: 15652604
references: Hypertension. 2009 Mar;53(3):458-65
references: 19188527
references: J Hypertens. 2003 Nov;21(11):1983-92
references: 14597836
references: Am J Hypertens. 2008 May;21(5):509-13
references: 18437141
references: Ann Fam Med. 2010 Jan-Feb;8(1):19-24
references: 20065274
references: J Gen Intern Med. 2004 Jun;19(6):638-45
references: 15209602
references: N Engl J Med. 2011 Dec 1;365(22):2088-97
references: 22080794
references: Am J Manag Care. 2010 Aug;16(8):568-76
references: 20712390
references: J Clin Hypertens (Greenwich). 2010 Sep;12(9):706-13
references: 20883231
references: Clin Cardiol. 2007 Apr;30(4):183-7
references: 17443660
references: Am J Manag Care. 2006 Dec;12 Spec no.:SP11-9
references: 17173486
references: J Cardiovasc Pharmacol. 2000;35 Suppl 3:S23-6
references: 10854048
references: Health Aff (Millwood). 2007 Jan-Feb;26(1):13-24
references: 17211010
references: J Health Care Poor Underserved. 2006 Feb;17(1):70-85
references: 16520513
references: Am J Manag Care. 2012 Apr;18(4):193-9
references: 22554007
references: Int J Clin Pract. 2010 Jan;64(2):169-81
references: 20089007
references: N Engl J Med. 2005 Aug 4;353(5):487-97
references: 16079372
references: BMC Health Serv Res. 2008 Jul 29;8:161
references: 18664285
references: Lancet. 2008 May 3;371(9623):1513-8
references: 18456100
references: J Hypertens. 2009 Jul;27(7):1472-7
references: 19474763