Abstract
High medication costs may be a significant cause of nonadherence and threaten recent gains in hypertension treatment. It is unclear whether prescribing patterns differ with patients' insurance coverage. The objective of this study was to determine whether insurance coverage, reported difficulty affording medications, or nonadherence were associated with antihypertensive prescribing in a high-risk population. The authors conducted a cross-sectional survey of 189 patients admitted to an inner-city academic hospital with severe, poorly controlled hypertension. Patients' poor medication access (one-third lacked insurance and half reported difficulty affording medications) was not associated with admission or discharge regimen costs. Substituting the least expensive drug within each class would have reduced costs by 42%, and reducing calcium channel blocker use would have significantly reduced costs. In conclusion, markers of poor medication access were not associated with prescribing patterns. Further research is needed to explore these patterns and their impact on vulnerable populations' financial burden and adherence.