Earlier this month at an American College of Cardiology meeting, Dr. Tracy Wang, Associate Professor at Duke School of Medicine, presented preliminary findings on a study involving 11,000 heart attack patients in 300 U.S. hospitals. Funded by the drug maker AstraZeneca, the ARTEMIS study aimed to understand which blood-thinning drugs patients were being prescribed in the wake of their heart attacks and how well those patients stuck to the prescribed medicine over the course of a year. In particular, researchers wanted to understand if the high-cost but more effective brand-name drug (ticagregol) would be more commonly prescribed and used if patients were provided a voucher to offset its extra cost compared to an older generic therapy called clopidogrel.

Hospitals were randomly assigned to a “care as usual” arm and a “co-pay intervention arm” – in the latter, price-equalizing vouchers were available for all patients and doctors were given discretion to prescribe either type of treatment. As expected, clinicians were more likely to prescribe the more effective brand-name drug when they knew patients would not be facing a higher cost. Additionally, patients who received vouchers and used them were more likely to continue taking the medication as prescribed over the course of a year. However, there was no difference in death rates, heart attacks, or strokes between those in the voucher group and the “care as usual” group.

The preliminary results indicate that cost is a huge factor when doctors choose which treatments to prescribe and when patients decide to fill – or not fill – prescriptions. However, reducing cost alone is not sufficient to improve health outcomes. Broader interventions are needed to improve patient health and co-payment reduction can be an important piece of a multi-pronged approach. As Dr. Wang explained, “Our study confirms some of our thoughts on how drug prices affect doctors’ and patients’ behaviors, but we still have a lot of work to do to understand how we can both measure and improve treatment adherence.”

Interested in learning more about the ARTEMIS study? Watch Dr. Wang’s informative overview of the study or read this detailed coverage of the preliminary results.