Did Providing Free Essential Medicines Increase Adherence?

JAMA Internal Medicine


Media advisory: To contact corresponding author Navindra Persaud, M.D., M.Sc., C.C.F.P., email Michael Oliveira at Michael.Oliveira@unityhealth.to. The full study is linked to this news release.

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Bottom Line:More patients who said they couldn’t afford their medications adhered to treatment when they received free essential medicines for one year in a randomized clinical trial, but not all measures of health outcomes improved. The trial enrolled 786 patients (764 completed it) at nine primary care sites in Ontario, Canada. Patients were randomly split into two groups: 395 received free essential medicines plus usual care and 391 had usual care and usual access to medicines. Medicines aren’t universally publicly funded in Canada like hospitalizations and physician care are. Free medicines included in the trial were treatments for chronic conditions, such as antipsychotics, antiretrovirals, glucose-lowering medicines and antihypertensives, and for acute conditions, such as antibiotics and analgesics. Researchers report more people who received free essential medicines were appropriately adherent (151 of 395 or 38.2%) compared with those in the group with usual access to medicine (104 of 391 or 26.6%). The free distribution of medicine reduced systolic blood pressure among those prescribed an antihypertensive but it didn’t significantly improve low-density lipoprotein cholesterol levels and there was a nonsignificant improvement in diabetes control (decrease in hemoglobin A1c ) in those prescribed treatment to control diabetes. The importance of these findings from one high-income country should be applied cautiously to other locales with different health care systems.

Authors: Navindra Persaud, M.D., M.Sc., C.C.F.P., of St. Michael’s Hospital, Toronto, and coauthors



Editor’s Note: The article includes conflict of interest and funding/support disclosures. Please see the article for additional information, including other authors, author contributions and affiliations, financial disclosures, funding and support, etc.

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