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(Circulation. 2008;117:1252-1254.)
© 2008 American Heart Association, Inc.

Editorial

Strategies to Improve Medication Compliance by Medicare Beneficiaries

Gail R. Wilensky, PhD

From Project HOPE, Bethesda, Md.

Correspondence to Dr Gail R. Wilensky, Senior Fellow, Project HOPE, 7500 Old Georgetown Rd, Bethesda, MD 20814. E-mail gwilensky@projecthope.org

Key Words: Editorials • myocardial infarction • Medicare

An extract of the first 250 words of the full text is provided, because this article has no abstract.

	Introduction

 
In the article in this issue by Choudhry et al,¹ the authors assess whether eliminating out-of-pocket costs would be an effective way to improve medication compliance in Medicare patients after they have experienced an acute myocardial infarction (MI). The specific questions the authors raise are whether full coverage would be cost-effective using the traditional values for such measurements and whether full coverage would actually save Medicare money by reducing health expenditures outside of the pharmacy area. For those of us who live in the policy world of Washington, this is an important issue, because if the additional coverage can be demonstrated to save Medicare money elsewhere, the change in coverage would not be regarded as an increase in spending but rather as a savings to the program. Under current Congressional rules, increased expenditures—even useful ones—need to be offset by either reduced expenditures elsewhere or by increased tax revenue. This means that being able to demonstrate the net effect of a change in coverage on overall Medicare spending (as well as on overall health spending) becomes an important budget matter as well as an important health policy issue.

Article p 1261

The more general problem that the article by Choudhry et al¹ addresses is how best to improve the notoriously low compliance rates regarding the use of proper medications, along with other preventive strategies in the secondary prevention of coronary artery disease. One such strategy is to eliminate all out-of pocket costs; however, other strategies are also available, such as chronic . . . [Full Text of this Article]