Removal of Special Authority requirements for clopidogrel improved optimal care following percutaneous coronary intervention across sociodemographic groups
Suneela Mehta, Sue Wells, Rod Jackson, Jeff Harrison, Andrew Kerr
Clopidogrel is a medication that was routinely used until mid-2012 to reduce the risk of clots forming within blood vessels in the heart after percutaneous coronary intervention (a common procedure used to unblock narrowed arteries in the heart). We examined if optimal clopidogrel therapy following percutaneous coronary intervention (PCI) changed by age, sex, deprivation status or ethnic group during and after special authority funding restrictions, which required hospital-specialist approval for full funding. After funding restrictions were lifted, optimal clopidogrel therapy following PCI improved by 7% across all sociodemographic groups. Irrespective of funding restrictions, almost all eligible patients received some clopidogrel therapy and there were few differences in optimal clopidogrel use between men and women, younger and older people and more and less deprived groups. However, Maori and Pacific peoples were less likely to have optimal clopidogrel therapy compared to non-Maori/non-Pacific/non-Indian patients before and after funding restrictions were removed.