Want Cash Prizes? Take Your Meds-July 2008

University

Pennsylvania

of

A study is offering a novel approach to get patients to take their medications—a daily shot at winning $10 or $100.

The study, funded by the Aetna Foundation, is still in the beginning stages. Troyen Brennan, MD, MPh, Aetna chief medical officer, said the lottery-like program is worth studying the cash effect on encouraging patients to take their medications.

Hartford Courant

“From a public health point of view, this is a very sensible thing to do,” said Dr. Brennan in the June 22, 2008, issue of the . “It recognizes that simply exhorting people to do what’s best for themselves isn’t going to work and that we need to come up with other more innovative ways to improve people’s health care and recognize that people don’t comply with their medication regimen.”

The study, which will focus on patients who take warfarin, has enrolled more than half of the 100 adult patients, and each will be monitored for 180 days. Of the participants, 50 will play the lottery and 50 will serve as the control group. The patients eligible for the cash prizes will each be assigned a number for the daily drawings. The researchers will look at whatever the increase in compliance is from the lottery and estimate how much health care spending was avoided.

All participants in the study have to remember to take their warfarin once a day from a Med-eMonitor pillbox. Overnight, the box transmits results over a phone line to a secure computer server. While the device’s reminder mechanism will not be turned on for the study duration, it will ask patients whether they are taking the medicine and they must press a button to indicate yes. This puts those patients eligible for the cash prizes into that day’s drawing. The winners are notified each morning with a message sent back over the phone line.

Stephen E. Kimmel, MD, coprincipal investigator on the study, said once the warfarin lottery results are in, “then we have to have a discussion about whether and when it’s appropriate to use [a lottery], if at all.” Some results are expected early next year.