Adherence, Switches, and Drug Spending After Angiotensin Receptor Blocker Recalls and Shortages

How did antihypertension medication use and drug spending change after shortages for angiotensin II receptor blockers (ARBs; valsartan, irbesartan, and losartan) from 2018 to 2019?In this cohort study of 13.8 million ARB users, mean adherence to antihypertension medications did not change within 18 months after the ARB recalls, though many users of recalled ARBs switched to alternatives within 90 days, with no associated increase in insurer or out-of-pocket drug spending. Increases in switching were lower among Medicaid fee-for-service beneficiaries and customers paying in cash vs those with Medicare or third-party insurance.Switches to alternatives likely mitigated gaps in treatment during the ARB shortages, and differences by insurance highlight the need for policies to address systematic barriers to receiving health care during drug shortages.

Corresponding Author: Katherine Callaway Kim, PhD, MPH, Department of Health Policy and Management, University of Pittsburgh School of Public Health, 3609 Forbes Ave, 2nd Floor, Pittsburgh, PA 15213 (kac377@pitt.edu).

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