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Some suffer side effects; some of these medicines can cause fatigue, lightheadedness, muscle pains, cough _ even sexual difficulties for men. That may seem like a high price to pay when you’re suffering one of these versus a less tangible prevention benefit.

Even former President Bill Clinton confessed he had stopped taking his cholesterol medicine after leaving office in 2001. He later developed severely clogged arteries that required heart bypass surgery in 2004.

In the study, the main outcome being tracked _ the first major heart problem or need for an artery-unclogging procedure _ was no different between the groups.

However, the total number of heart attacks, strokes, cases of chest pain or heart failure and other such problems was significantly lower in the group offered free medicines. It meant that an additional 2 of every 100 people were spared such problems because of being offered free medicines, and doctors suspect the difference between the groups would have been greater if more people had filled their prescriptions.

Costs dropped 26 percent for patients in the free drug group compared to the others _ about $500 on average _ partly because of fewer doctor visits, lab tests and hospitalizations.

Costs for the insurer averaged $69,997 over the next year for those with usual coverage and $64,726 for those offered free medicines. That wasn’t considered a big difference statistically, but from an actuarial standpoint, could matter to an insurer, Aetna’s Reisman said.

Providing such important medicines for free had a “distressingly modest” impact on patients’ willingness to take them, Dr. Lee Goldman of Columbia University and Dr. Arnold Epstein of the Harvard School of Public Health write in an editorial in the medical journal.

They note that common generic medicines cost less than the average copays faced by patients in the study, and speculate that the results should spur interest by other insurers “even if the business case does not yet indisputably confirm lower costs for them.”

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Online:

Heart Association: http://www.americanheart.org

New England Journal: http://www.nejm.org

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Marilynn Marchione can be followed at http://twitter.com/MMarchioneAP