Stroke medication unaffordable for many survivors

Younger stroke survivors, those who are uninsured and those covered by Medicare Part D drug benefits often cannot afford medications, study results reveal.

“Federal programs to reduce cost-related nonadherence to medication may not be working as intended and a resulting large number of stroke survivors are at risk for subsequent stroke events,” Deborah A. Levine, MD, MPH, of the University of Michigan in Ann Arbor, said at the American Stroke Association's 2011 International Stroke Conference.

Levine and colleagues measured nonadherence to prescription drugs among 2,656 stroke survivors aged 45 years or older who participated in the National Health Interview Survey between 2006 and 2009.  They then compared patient responses to survey data collected between 1998 and 2002, before Medicare Part D was implemented (Abstract #212).

The researchers found that although more people appear to be surviving stroke (33% vs. 38%), 11%, or about 150,000 stroke survivors, reported that they couldn't afford their medication.

Cost-related nonadherence to stroke medications increased the most among uninsured stroke survivors, from 39% to 60%.  Significant increases were also noted among younger stroke survivors, particularly those aged 45 to 54 years. The researchers suggested that this could be attributable to competing household costs or less prescription drug coverage, and noted that medication adherence rates remained constant among older stroke survivors.

Surprisingly, Medicare recipients who had prescription drugs covered through Medicare Part D (42%) had higher rates of cost-related nonadherence compared with beneficiaries that did not have prescription drug benefits (12% vs. 6%; P<.001).

“Healthcare professionals need to screen for cost-related barriers to medication in stroke survivors, particular those who are younger, uninsured or enrolled in Medicare Part D, and to improve access to affordable medications for post-stroke patients who need it,” Levine said.

She suggested that simply asking patients about their ability to afford acre may help reduce the risk of recurrent stroke and other cardiovascular events.

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