Giving patients free essential medicines seems to improve adherence, study says

Researchers wanted to find out if providing free essential medicines increased adherence among patients who could not afford their medications. While not all measures of health outcomes improved, they found that more patients who received free essential medicines for 1 year in a randomized clinical trial adhered to treatment. The study findings were published on October 7 in JAMA Internal Medicine.

The trial took place at nine primary care sites in Ontario, Canada. Unlike hospitalizations and physician care, medications are not universally publicly funded in Canada. The research team split 786 patients into two groups, with the first group receiving free essential medicines plus usual care and the second group receiving usual care and access to medications. Of the 764 patients who completed the year-long trial, adherence was higher in the group randomized to receive free essential medicines (38.2%) than in the group receiving usual access to medicine (26.6%).  

The free medications patients received were based on a list of 128 essential medicines adapted from the 2013 World Health Organization, as well as Canadian clinical practice guidelines and suggestions from clinicians and patients. The medications were used to treat chronic conditions—antipsychotics, antiretrovirals, glucose-lowering medicines and antihypertensives, to name a few—as well as antibiotics and antihypertensives, for example, for acute conditions.

Some health outcomes that were not affected by the receipt of free medication included control of type 1 and type 2 diabetes. There was also no significant improvement in LDL-C levels among the study participants. However, the free distribution of medicine did reduce systolic blood pressure among those prescribed an antihypertensive, according to the findings.

In their conclusion, the authors wrote that the findings could help inform changes to medicine access policies, such as publicly funding essential medicines.