The impact of medication switches induced by medication discount contracts on chronic patients’ adherence (Artikel)

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The impact of medication switches induced by medication discount contracts on chronic patients’ adherence (Artikel)
Autor Antje Groth, Sabrina Müller, Thomas Wilke
In: Value in Health
Ausgabe 13 (7)
Erscheinungsjahr 2010
Jahrgang November 2010
Seitenzahl A360

OBJECTIVES: Switching of medications due to non-medical grounds may be a critical factor infl uencing patients’ medication-based adherence (NA). The aim of this analysis is to examine the effects of medication switching on NA for hypertonic/diabetic (type II) patients. Only switches between medications containing the same active ingredient were examined. METHODS: Prescriptions fi lled at 5 German pharmacies over a period of 2 years were analyzed. Patients who had fi lled prescriptions for at least 3 medications to control hypertonia (focus on Moxonidin—ATC-Code C02AC05) and/ or diabetes type 2 (focus on Metformin—ATC-Code A10BA02) were included. The NA was calculated using the medication possession ratio (MPR); NA was defi ned as MPR < 80%. The average MPRs obtained while using the original and the discount products (before/after comparison) were compared using non-parametric tests for independent samples (Wilcoxon-Tests). RESULTS: Of the 344 hypertonia sufferers, 253 received the active ingredient Moxonidin (NA patients’ percentage: 47.4%). In 68 cases, a switch to the discount product took place (NA percentage before switch: 46.4%). The percentage of NA patients was reduced to 39.1% after the switch. Of the 726 diabetic patients, 518 patients received Metformin (NA: 49.4%). a total of 136 patients received a discount article after the discount contract was in place (NA before switch: 42.7%). After the switch, the NA percentage increased to 66.2%. CONCLUSIONS: In the case of hypertonia, medication switches had no signifi cant effect on the NA. By contrast, switchers receiving Metformin exhibited a substantial increase in medication-based NA. In future, the focus of research in this area should be to discover whether specifi c contracts concerning discount products (as, for example, in the case of Metformin) are related to particularly negative adherence effects and if so which factors infl uence such effects.