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Health Aff (Millwood). 2007 Jan-Feb;26(1):186-94.

Should patients receive secondary prevention medications for free after a myocardial infarction? An economic analysis.

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  • 1Harvard Medical School and Brigham and Women's Hospital, Boston, Massachusetts, USA.


Taken in combination, aspirin, beta-blockers, angiotensin-converting enzyme (ACE) inhibitors, and statins (combination pharmacotherapy) greatly reduce cardiac events. These therapies are underused, even among patients with drug insurance. Out-of-pocket spending is a key barrier to adherence. We estimated the impact of providing combination pharmacotherapy without cost sharing ("full coverage") to insured patients after a myocardial infarction (MI). Under base-case assumptions, compared to standard coverage, three years of full coverage will reduce mortality and reinfarction rates and will save 5,974 per patient. Our analysis suggests that covering combination therapy for such patients will save both lives and money.

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