One could argue that virtually everything one does, and does not do, influences thinking and decisions, so where are the boundaries?
Patients who paid for heart medications solely through U.S. Medicare were 57 percent more likely not to take them during coverage gaps, researchers say.
Study leader Jennifer M. Polinski, an instructor in medicine at Harvard Medical School in Boston, said during the study, the Medicare prescription drug benefit -- Medicare Part D -- stopped paying for medicine when spending reached a certain level, or the "doughnut hole."
Payments resumed when patients' out-of-pocket expenses reached qualifying levels or the benefit restarted in the next calendar year, Polinski said.
"Rather than prompting patients to switch to lower-cost alternatives, we found that sudden exposure to 100 percent of drug costs in the Part D coverage gap led to abrupt discontinuation of essential cardiovascular medications," Polinski said in a statement. "Any drug insurance policy that negatively influences essential cardiovascular drug use needs to be changed."
Patients who did not receive financial assistance during the coverage gap were no more likely to die or be hospitalized for cardiovascular-related conditions than those who did have financial assistance -- a contrast with previous research results. The difference could be due to the current study's relatively short follow-up of 119 days -- the typical amount of time patients spent in the coverage gap, said Polinski.
The findings were published in Circulation: Cardiovascular Quality and Outcomes.