The Pharmacy Chick

Flying the coup in retail

Not even when its free?

Filed under: Uncategorized — pharmacychick at 10:50 pm on Wednesday, November 16, 2011

I found it interesting when I was reading the paper yesterday and buried in the middle was the results of a study done ( by Aetna) that wanted to see if patient compliance would improve if drugs were  offered to the patients FREE.

Two groups were compared, one that had their drugs provided free of charge and the second,which had a copay.  One might think that it would be a slam dunk conclusion: Free drugs would drastically improve compliance.

If you think that, you would be wrong.

Apparently even Free isn’t a good enough price.  Copied from the original article:

The study enrolled 5,855 Aetna members who had a drug plan as part of their benefits and were going home from the hospital after a heart attack. They were 53 years old on average, and three-fourths were men.

The researchers had hoped to recruit 7,500 patients but scaled back when so few signed on.

Preventive medicines were offered free to 2,845 patients and prescribed with the usual copayments for the rest. Copays for these drugs run around $50 a month.

Roughly a year later, the share of patients who filled their prescriptions ranged from 36 percent to 49 percent in the copay group, depending on the drug, and was only 4 to 6 percentage points higher in the group that had no copays.

Providing these medicines for free had a “distressingly modest” effect on patients’ willingness to take them, Dr. Lee Goldman of Columbia University and Dr. Arnold Epstein of the Harvard School of Public Health wrote in an editorial in the medical journal.

Comments?? Tell me what you think about this study, and why you think it turned out the way it did!


Comment by pj

November 17, 2011 @ 1:26 am

Because free medicine has no worth and is therefore worthless.

Comment by Tracy

November 17, 2011 @ 3:39 am

Good question. You WOULD think th mind set would be “might was well take it” when its free.
My guess is that the ppl that did have to pay for them maybe didn’t want to waste their money by NOT taking them.
Some of my pharmacy’s most non compliant pts are the ones on state funded Medicaid. randomly thruout the year we’ll get the call to “fill everything” even their blood pressure med, that when asked they take every single day without fail, hasn’t been filled since February. and oh yeah its August. these ppl seem to live forever.

Comment by sir_dispensalot

November 17, 2011 @ 5:30 am

In the UK most people get free medicines on prescription as part of the national health service or get them at a fixed fee per item, whether the drug costs £1 or £1000. Compliance is often terrible as patients no longer see the cost or value in what they are taking – there is a general perception of “what can i get for free?” from the pharmacy. Why did they bother doing that survey when they could have simply sent an email to our NHS to see the effects of free medication?…(of course there will always be the claim of cultural differences therefore slightly differing results, but still…)

Comment by WarmSocks

November 17, 2011 @ 7:43 am

It has no value if it’s free. Missionaries run into this all the time when treating people with donated medicines. The impression seems to be that if it’s not worth charging for, then it’s not worth using.

Comment by Mallory

November 17, 2011 @ 7:49 am

Preventative medications often have low compliance because there is no immediate reinforcement. As far as the patient can see, there’s no short-term difference to their health if they take it or not. Price won’t change this.
Anything that has an immediate impact (eg, a pain medication, anti-nausea medication) or withdrawal symptoms, is more likely to be complied with.

Comment by Emma

November 17, 2011 @ 8:27 pm

Not surprising … how many free medicaid prescriptions do you return to stock every month? If your store is anything like any of the pharmacies I’ve ever worked at it’s a ridiculous number, and it’s NOT just the preventative meds that the patient sees an immediate benefit from.
I think there are 2 factors at play. One, yes, someone is less likely to take something that they can’t “see” working. Secondly, taking medication on a daily basis requires some personal responsibility, which is severely lacking in our society.

Comment by pharmaciststeve

November 18, 2011 @ 7:56 pm

The 50% that is non-complaint will probably be the same ones that will expect “whatever it costs” to be done when they are at “death’s door”. When we start rationing care.. hopefully these will be placed first in line.

Comment by Loren Pechtel

December 14, 2011 @ 7:25 pm

To their eyes the preventatives only cause side effects. Is it any wonder plenty of people don’t take them?

Comment by R. May

January 19, 2012 @ 1:57 pm

I’m late to the game but I think a lot of commentators missed the point on this one. They were just as non-compliant when they had to PAY for the meds. Therefore the cost of meds whether free or $50.00 is NOT a particularly strong factor in compliance. So reiterating the oft touted anecdotal statement that free has no value and that’s why all those people of medicare/caid/state health dont’ take their meds is not a fair argument. Where is the proof? This study, though not vast, shows the interesting point that price simply doesn’t matter. So lets figure out what does.

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