Free Medication Increases Adherence for Patients Struggling to Afford Treatment

Many programs have recently been introduced that provide essential medicines for free to patients who would otherwise be unable to afford them. According to data from a JAMA Internal Medicine study, this practice improves adherence.

A clinical trial conducted by Navindra Persaud, MD, department of family and community medicine of the University of Toronto, and colleagues, examined the effects of distributing free essential medication to 786 primary care patients.

“Patients were randomly allocated to receive free medicines on a list of essential medicines in addition to otherwise usual care (n=395) or usual medicine access and usual care (n=391),” explained the researchers.

The free medications included “treatments for acute conditions (eg, antibiotics and analgesics) and chronic conditions (eg, antipsychotics, antiretrovirals, glucose-lowering medicines, and antihypertensives).”

“The primary outcome was adherence to treatment with all medicines that were appropriately prescribed for 1 year,” researchers explained in the study’s abstract. “Secondary outcomes were hemoglobin A1c level, blood pressure, and low-density lipoprotein cholesterol levels 1 year after randomization in participants taking corresponding medicines.”

At completion of the trial, Dr Persaud and colleagues reported improved adherence. A 38.2% increase in number of patients appropriately adhering to all medicines was observed in the group that was chosen to receive free medicines, compared with only 26.6% increase in the usual access group.

Free distribution of medication also had positive effects on health, lowering systolic blood pressure and improving diabetes control.

Dr Persaud and colleagues note that this data could help inform policy changes in Canada, including publicly funding a list of essential medicines. Free distribution has the most potential to improve health outcomes for patients with cardiovascular disease, HIV, and AIDs—for which medication and treatment options are often inaccessible to many due to cost.

 “Although improving medicine adherence is difficult…even relatively small increases in adherence to effective treatments seem to improve health outcomes such as cardiovascular events or reduce mortality such as HIV- and AIDS-related mortality in higher risk individuals,” concluded Dr Persaud and colleagues.

Programs in the United States have been recently implemented where free medication is distributed to those who qualify. Ready, Set, PrEP is an example of a program in the United States that was born of a collaboration between Gilead Sciences and the US Department of Health & Human Services in which individuals who have valid prescriptions and are uninsured, are able to receive pre-exposure prophylaxis (PrEP) for free. —Edan Stanley