A Randomized Evaluation of First-dollar Coverage for Post-MI Secondary Preventive Therapies (MI FREEE)

Experimental: 1

Otro: Full drug coverage

Patients randomized to first-dollar coverage will have their pharmacy benefits changed so that they have no out-of-pocket costs for any beta-blocker, angiotensin converting enzyme inhibitor (ACEI) or angiotensin II receptor blocker (ARB) antagonist, or statin for every subsequent prescription after randomization. All co-pays and co-insurance will be waived at the point of care (i.e. pharmacy) as will any contribution that the cost of these drugs contributes to a patient's deductible

Comparador activo: 2

Otro: Usual coverage

Patients randomized to usual coverage will have no change in their existing benefits

First occurrence of fatal or non-fatal acute MI, unstable angina, stroke, congestive heart failure, or revascularization (coronary bypass, stent insertion, or angioplasty)

First occurrence of fatal or non-fatal acute MI, unstable angina, stroke, or congestive heart failure

First occurrence of fatal or non-fatal acute MI, unstable angina, stroke, or congestive heart failure or out-of-hospital cardiac death

Rate of fatal or non-fatal acute MI, unstable angina, stroke, congestive heart failure, or revascularization (coronary bypass, stent insertion, or angioplasty)

Medication adherence (i.e. the mean medication possession ratio and the proportion of patients fully adherent to each and all 3 of the study medications)

Health care utilization (i.e. use of physician visits, emergency room admissions, hospitalizations or other resources)

Total pharmacy and health care costs