News in brief - Dec. 12, 2011

Drug compliance not much higher when patients pay nothing - Wisconsin explores options to stem physician shortages

Drug compliance not much higher when patients pay nothing

Eliminating co-pays appears to have little effect on patients' medication adherence or clinical outcomes, according to a Dec. 1 study in The New England Journal of Medicine. Nearly 6,000 Aetna patients who had been recently discharged from the hospital after a heart attack were involved in the study. About half were given ACE inhibitors, beta-blockers and statins at no charge, while the others continued to pay monthly out-of-pocket costs of $25 or less for these medications.

Yet only 44% of the free-drug group took their medicines, compared with 39% of the usual-cost group. More important, there was no statistically significant difference in outcomes, with the two groups of patients experiencing a similar number of fatal or nonfatal vascular events, the study said.

Patients who received drugs for free racked up about 8% less in medical charges -- nearly $5,300 on average -- due to fewer physician visits and other nonmedication health care expenses. The slightly improved drug compliance in this group may have reduced its health care utilization, the study said.

Wisconsin explores options to stem physician shortages

Wisconsin must take swift and aggressive action to avert physician shortages during the next 20 years or risk the long-term loss of certain health care services, says a November report by the Wisconsin Hospital Assn.

Hospital association officials estimate that the state must hire 100 new physicians annually to keep up with patient care demands. Without that increase, Wisconsin will have a shortfall of more than 2,000 physicians by 2030, says the report (www.wha.org/data/sites/1/pubarchive/reports/2011physicianreport.pdf).

Tackling the problem will require significant changes to the state's medical education and physician training systems. The report outlines several possible actions, including expanding residency programs, opening a new medical school or satellite campuses to existing schools, and offering incentives to keep medical students from leaving the state after graduation.