Out‐of‐Pocket Costs and Antihypertensive Medication Use Among Veterans: A Natural Experiment

Journal of the American Heart Association 2026 Open access

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Authors: Alexander R. Zheutlin, Alexander Chaitoff, Daniel K. Addo, Joshua A. Jacobs, Catherine G. Derington, Eric Lee Stulberg, Peter A. Glynn, Bernardo Modenesi, Jordana B. Cohen, Adam Phillip Bress
DOI: 10.1161/jaha.125.047792
Cited by: 1
References: 45

Abstract

BACKGROUND: Blood pressure (BP) control remains suboptimal in the United States despite available low-cost antihypertensive medications. Even small out-of-pocket medication costs may contribute to adherence. We determined whether $0 versus >$0 out-of-pocket costs for antihypertensive medications is associated with differences in adherence, discontinuation, BP control, and cardiovascular outcomes. METHODS: We included veterans with newly diagnosed hypertension who initiated antihypertensive medication in the Veterans Health Administration from 2004 to 2022. A fuzzy regression discontinuity design with 2-stage residual inclusion leveraged differences in medication copay policy at a 50% service-connected disability threshold (≥50% service-connected disability: $0 out-of-pocket cost versus

Fields of Study & Subjects

Medication Adherence and Compliance Economic and Financial Impacts of Cancer Blood Pressure and Hypertension Studies

Publication details

Journal / source
Journal of the American Heart Association
Publisher
Ovid Technologies (Wolters Kluwer Health)
Volume
15
Issue
8
Pages
e047792–e047792
Publication date
9 April 2026
Language
EN