THE COSTS OF INTERRUPTING ANTIHYPERTENSIVE DRUG-THERAPY IN A MEDICAIDPOPULATION

This research explores the association between the interruption or ter mination of antihypertensive drug therapy and total health care costs among non-institutionalized Medicaid patients older than age 40 who su rvive the first year after treatment. Multivariate regression analysis was used to estimate the statistical relationship between post-treatm ent costs and patient demographic characteristics, prior use of servic es, the type of medication used as initial therapy and whether the pat ient maintained continuous therapy. Paid claims data from the Californ ia Medicaid (Medi-Cal) program were used in the analysis. Total cost o f health care in the first year after the initiation of drug therapy w as the primary outcome variable. Components of total costs (e.g., hosp ital, outpatient and physician services, prescription drugs) were also investigated. Nearly 86% of new antihypertensive drug therapy patient s interrupted or discontinued purchasing any form of antihypertensive medication during the first year. Patients with interrupted antihypert ensive drug therapy consumed an additional $873 per patient (P < .0001 ) in health care during the first year, not counting a reduction in pr escription drug cost of $281 (P < .0001). Increased costs were primari ly due to increased hospital expenditures of $637 (P < .0002).