Unlocking health equity by eliminating copayments for essential antihypertensive medications

Hypertension kills more people than any other condition; approximately 80% of deaths occur in low- and middleincome countries (LMICs). Only about 1 in 5 adults with hypertension worldwide and less than 1 in 10 in LMICs have their condition controlled. Adherence to antihypertensive medications increases control and decreases hospitalizations, strokes, heart attacks, and health care costs. Eliminating patient copayments for antihypertensive medications increases adherence and hypertension control. This powerful but underutilized strategy can advance universal health coverage and reduce economic hardship. Medication access with no out-of-pocket cost to patients is feasible and economically sound, but requires increased investment and careful implementation to avoid unintended consequences of reducing flexible funding needed for primary health care systems. Provision of medications that are free to patients at the point of care should be part of a multi-component, sustainable approach to addresses systemic barriers to treatment of hypertension, the world's leading cause of death.