#VisualAbstract: Effect of Medication Co-payment Vouchers on P2Y12 Inhibitor Use and Major Adverse Cardiovascular Events Among Patients With Myocardial Infarction The ARTEMIS Randomized Clinical Trial

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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