These researchers investigated whether optimal clopidogrel therapy following percutaneous coronary intervention (PCI) differed systematically by sociodemographic characteristics during and after Special Authority funding restrictions, which required hospital-specialist approval for full funding. The study population included all New Zealanders with publicly-funded admissions for PCI who were discharged between 1 July 2009 and 31 December 2009 (while SA criteria for clopidogrel were applicable) and from 1 September 2010 to 28 February 2011 (after removal of SA requirements). Data were analysed from 2146 patients discharged following PCI during the last 6 months of 2009 and from 2347 patients discharged in the 6 months immediately following removal of SA restrictions. During the first discharge period, an overall 74% of patients had optimal clopidogrel dispensing (i.e., a medicine possession ratio [MPR] ≥0.8). After funding restrictions were lifted, optimal clopidogrel therapy following PCI improved to 81% across all sociodemographic groups. In both discharge periods, 2–3% of patients received no therapy. 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, optimal clopidogrel-dispensing was 13–14% less likely among Māori and Pacific peoples relative to non Māori/non-Pacific/non-Indian patients during funding restrictions. These findings for ethnic differences did not change appreciably once funding restrictions ended, despite absolute increases in dispensing.
