Effect of medication copayment vouchers on P2Y12 inhibitor use and MACE among patients with MI

Researchers for the ARTEMIS trial sought to determine the effect of vouchers to cover copayment costs for P2Y12 inhibitors on medication persistence and major adverse cardiovascular events (MACE) among patients with acute myocardial infarction (MI).

Researchers for the ARTEMIS trial sought to determine the effect of vouchers to cover copayment costs for P2Y12 inhibitors on medication persistence and major adverse cardiovascular events (MACE) among patients with acute myocardial infarction (MI). Data show that post-MI, 30%–60% of patients do not complete a 1-year course of treatment with P2Y12 inhibitors. The cluster randomized clinical trial included 301 hospitals that enrolled about 11,000 adults with acute MI. Hospitals randomized to the intervention gave patients copayment vouchers for clopidogrel or ticagrelor for 1 year, with the median value of the vouchers $137 for a 30-day supply. Hospitals that were randomized to usual care did not provide vouchers. At 1 year, patient-reported persistence with P2Y12 inhibitors was higher in the intervention group compared with the control group, with rates of 87% vs. 83.8%. According to the researchers, however, there was no significant difference in MACE between the two groups at that point.