1. In this randomized controlled trial, medication vouchers were associated with a small increase in patient-reported persistence with P2Y12 inhibitors for patients who had suffered a myocardial infarction (MI).
2. Medication vouchers were not associated with reduced major adverse cardiovascular events (MACE) in these patients.
Evidence Rating Level: 1 (Excellent)
Study Rundown: Antiplatelet therapy, such as with P2Y12 inhibitors, is recommended for up to 1 year after myocardial infarction (MI). However, inability to afford the medication is often cited as a significant barrier to medication adherence. In this randomized controlled trial, patients with MI who received vouchers for a P2Y12 inhibitor had a slight increase in patient-reported medication persistence. However, there was no significant difference in 1-year major adverse cardiovascular events (MACE).
Overall, while this study suggests vouchers for P2Y12 inhibitors may not have a significant impact on cardiovascular health in post-MI patients, some limitations should be noted. For one, the study may not be generalizable to patients receiving P2Y12 inhibitors for other indications nor non-US populations. Further research is warranted in understanding the economics of providing vouchers as a public health intervention to improve outcomes.
Click to read the study in JAMA
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