Docs Have An Idea For Insurers

A new study suggests insurers would be greatly rewarded financially if they removed the cost-sharing requirements imposed for certain medications taken by customers who had previously suffered a heart attack.

A combination of heart medications and cholesterol-lowering drugs has been estimated to reduce the risk of death from heart disease by 80 percent compared with a placebo. Yet, the medications continue to be greatly underused.

One answer to that problem would be to provide full coverage of the heart medicines to those who had a previous heart attack, instead of requiring the patient to pick up a share of that costs. Often the extra coverage could be entirely offset by the savings generated when health problems are averted, said researchers at Harvard Medical School.

Under conservative assumptions, compliance with a medication regimen would increase from 50 percent to 63 percent among patients when they bear none of the cost for the medicine.

The study estimates the additional coverage would cost insurers an average of $550 per patient, but that would lead to fewer deaths and nonfatal heart attacks and strokes, saving $1,731 in costs per heart-related event.

"If insurers can both boost compliance rates and prevent secondary heart disease events by shouldering these out-of-pocket costs, it's worth the investment," said Niteesh K. Choundry, an assistant professor at Harvard.

The researchers said that some 423,000 Americans with insurance for their medicine will have their first heart attack in 2006. They calculated that providing the patients with complete coverage for their heart medications could save 4,736 lives annually and save insurers more than $2.5 billion annually.