Wang TY, et al. - Patients often discontinue P2Y₁₂ inhibitor therapy earlier than the recommended 1 year following myocardial infarction (MI), despite guideline recommendations, and higher-potency P2Y₁₂ inhibitors are not used enough, so researchers investigated if removing co-payment barriers influence P2Y₁₂ inhibitor persistence and risk of major adverse cardiovascular events (MACE). They performed a cluster randomized clinical trial among 301 hospitals enrolling 11,001 adult patients with acute MI (median age, 62 years; 3,459 [31%] women). Patients were provided with co-payment vouchers for clopidogrel or ticagrelor for 1 year by the hospitals randomized to the intervention (n = 131 [6,436 patients]). No study vouchers were provided by hospitals randomized to usual care (n = 156 [4565 patients]). Observations revealed a 3.3% absolute increase in patient-reported persistence with P2Y₁₂ inhibitors and no significant reduction in 1-year MACE outcomes in relation to the provision of vouchers to offset medication co-payments for P2Y₁₂ inhibitors, vs no vouchers, among patients with MI.