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Kirsch, F. ; Becker, C. ; Kurz, C.F. ; Schwettmann, L. ; Schramm, A.*

Effects of adherence to pharmacological secondary prevention after acute myocardial infarction on health care costs – an analysis of real-world data.

BMC Health Serv. Res. 20:1145 (2020)
Verlagsversion DOI PMC
Open Access Gold
Creative Commons Lizenzvertrag
Background: Acute myocardial infarction (AMI), a major source of morbidity and mortality, is also associated with excess costs. Findings from previous studies were divergent regarding the effect on health care expenditure of adherence to guideline-recommended medication. However, gender-specific medication effectiveness, correlating the effectiveness of concomitant medication and variation in adherence over time, has not yet been considered. Methods: We aim to measure the effect of adherence on health care expenditures stratified by gender from a third-party payer’s perspective in a sample of statutory insured Disease Management Program participants over a follow-up period of 3-years. In 3627 AMI patients, the proportion of days covered (PDC) for four guideline-recommended medications was calculated. A generalized additive mixed model was used, taking into account inter-individual effects (mean PDC rate) and intra-individual effects (deviation from the mean PDC rate). Results: Regarding inter-individual effects, for both sexes only anti-platelet agents had a significant negative influence indicating that higher mean PDC rates lead to higher costs. With respect to intra-individual effects, for females higher deviations from the mean PDC rate for angiotensin-converting enzyme (ACE) inhibitors, anti-platelet agents, and statins were associated with higher costs. Furthermore, for males, an increasing positive deviation from the PDC mean increases costs for β-blockers and a negative deviation decreases costs. For anti-platelet agents, an increasing deviation from the PDC-mean slightly increases costs. Conclusion: Positive and negative deviation from the mean PDC rate, independent of how high the mean was, usually negatively affect health care expenditures. Therefore, continuity in intake of guideline-recommended medication is important to save costs.
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Publikationstyp Artikel: Journalartikel
Dokumenttyp Wissenschaftlicher Artikel
Korrespondenzautor
Schlagwörter Ami ; Dmp ; Guideline-based Medication ; Health Care Expenditures ; Pdc ; Secondary Prevention; Coronary-artery-disease; Converting-enzyme-inhibitors; Medication Adherence; Cardiovascular Events; Heart-disease; Statin Therapy; Drug-therapy; Claims Data; High-risk; Metaanalysis
ISSN (print) / ISBN 1472-6963
e-ISSN 1472-6963
Zeitschrift BMC Health Services Research
Quellenangaben Band: 20, Heft: 1, Seiten: , Artikelnummer: 1145 Supplement: ,
Verlag BioMed Central
Verlagsort Campus, 4 Crinan St, London N1 9xw, England
Nichtpatentliteratur Publikationen
Begutachtungsstatus Peer reviewed
Institut(e) Institute of Health Economics and Health Care Management (IGM)
Förderungen Projekt DEAL