Long-term cost-effectiveness of providing full coverage for preventive medications after XXXX .

@entity1 @entity583 @entity916
BACKGROUND: Adherence to drugs that are prescribed after @entity583 remains suboptimal. Although eliminating @entity1 cost sharing for secondary prevention increases adherence and reduces rates of major cardiovascular events, the long-term clinical and economic implications of this approach have not been adequately evaluated. METHODS AND RESULTS: We developed a Markov model simulating a hypothetical cohort of commercially insured @entity1 who were discharged from the hospital after @entity583 . @entity1 received b-blockers, @entity916 -angiotensin system antagonists, and statins without cost sharing (full coverage) or at the current level of insurance coverage (usual coverage). Model inputs were extracted from the Post @entity583 Free Rx Event and Economic Evaluation trial and other published literature. The main outcome was an incremental cost-effectiveness ratio as measured by cost per quality-adjusted life year gained. @entity1 receiving usual coverage lived an average of 9.46 quality-adjusted life years after their event and incurred costs of  171,412. @entity1 receiving full coverage lived an average of 9.60 quality-adjusted life years and incurred costs of  167,401. Compared with usual coverage, full coverage would result in greater quality-adjusted survival (0.14 quality-adjusted life years) and less resource use ( 4011) per @entity1 . Our results were sensitive to alterations in the risk reduction for post- @entity583 events from full coverage. CONCLUSIONS: Providing full prescription drug coverage for evidence-based pharmacotherapy to commercially insured post- @entity583 @entity1 has the potential to improve health outcomes and save money from the societal perspective over the long-term. CLINICAL TRIAL REGISTRATION INFORMATION: https://www.clinicaltrials.gov. Unique identifier: NCT00566774.
