Differential Cost-Sharing Undermines Treatment Adherence to Combination Therapy: Evidence from Diabetes Treatment

Nelson, David R.; Heaton, Pamela C.; Hincapie, Ana L.; Ghodke, Shirin; Chen, Jieling

doi:10.1007/s13300-021-01098-8

Cited by 3 publications

(3 citation statements)

References 31 publications

(38 reference statements)

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“…As mentioned in the literature review, patientoriented medicines supply information provision is important for supporting treatment adherence, achievement of better outcomes, and improvements of the patient satisfaction with healthcare services [25,26], especially for patients with rare and chronic diseases that require lifetime medication [13,14] and those in lower socioeconomic groups [9][10][11][12].Those patients must be provided with comprehensive information about available social and financial support as such patients are particularly vulnerable to unaffordable medicines and various social and health risks.…”

Section: Discussionmentioning

confidence: 99%

“…The patients' awareness about public medicines supply and health literacy are also considered as key aspects in public health [7,8]. In particular, low health literacy and a lack of information about social and financial support for medicines dispensation are associated with low medication adherence resulting from its high cost, especially for the lower socioeconomic groups [9][10][11][12] and those with chronic diseases that are rare or require lifetime medication, for example patients with diabetes mellitus [13,14].The Order of the Ministry of Health of Russian Federation no. 66, dated 13 February 2013, states the public provision of the full and comprehensible information as one of the main priorities of the strategy for medicines supply until 2025 [15].…”

Section: Introductionmentioning

confidence: 99%

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Evaluation of Patient-Oriented Medicines Supply Information on Russian Healthcare Providers’ Websites

Polukhin

Ekkert

Vodolagin

2021

JPRI

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Aims: To evaluate the Russian Federation healthcare providers’ websites compliance to legal requirements on availability of patient-oriented medicines supply information and compare the evaluation results between public and private healthcare facilities. Study Design: Cross-sectional study. Place and Duration of Study: The evaluation of compliance to legal requirements to medicines supply information on public and private healthcare providers’ websites available on the Internet was conducted in September 2021. Methodology: The study included a simple random sample of 66 websites of Russian healthcare providers containing two groups: public (n=33) and private (n=33) healthcare facilities’ websites. The compliance evaluation was performed by checking the availability of 4 medicines lists on the websites: (1) essential medicines list; (2) list of medicines for the most expensive chronic diseases to treat; (3) list of medicines that are prescribed only by shared decision of healthcare facility medical commission; (4) list of medicines that are dispensed for certain social groups with no charge or with 50% discount in outpatient care settings. Results: The difference of availability of the first list was 90.9% (95% CI 77.7%–97.4%) vs. 33.3% (95% CI 19.2%–50.3%) on public and private healthcare facilities’ website, respectively, P<.001. The difference of that in the second list was 42.4% (95% CI 26.8%–59.3%) vs. 15.2% (95% CI 6.0%–30.1%), P<.028. For the third no statistical significance was revealed (P>.05). For the fourth list the difference was 66.7% (95% CI 49.7%–80.8%) vs. 21.2% (95% CI 10.0%–37.2%), P<.001. Conclusion: It is required to improve the supervision approaches for both public and private healthcare facilities for better patient-oriented medicines supply information provision. The problem may be solved by the implementation of a centralized government policy repository with regularly updated lists, requirements, and best practices.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Evaluation of Patient-Oriented Medicines Supply Information on Russian Healthcare Providers’ Websites

Polukhin

Ekkert

Vodolagin

2021

JPRI

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“…Patients reporting insufficient financial means are also more significantly likely to not take medication as prescribed (e.g., skip doses, delay refills) [51]. Higher OOP costs have been tied to decreased adherence-one study demonstrated decreased antidiabetic medication adherence after monthly costs exceeded $33 [56].…”

Section: Insurance Coverage and Affordabilitymentioning

confidence: 99%

The Role of Sodium-Glucose Cotransporter-2 Inhibition in Heart Failure with Preserved Ejection Fraction

et al. 2022

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Sodium-glucose cotransporter-2 (SGLT2) inhibitors are a novel class of antidiabetic mediations found to also reduce cardiovascular morbidity and mortality and hospitalization for heart failure. Positive results from the EMPEROR-Preserved (empagliflozin) and PRESERVED-HF (dapagliflozin) studies led to recommendations for SGLT2 inhibitors in HFpEF within major international heart failure guidelines. However, studies of ipragliflozin and luseogliflozin, agents approved outside the United States (U.S.), reported different outcomes relative to pivotal trials and failed to realize benefits in the HFpEF population. Varying definitions of HFpEF and outcomes studied complicate the interpretation of study results. SGLT2 inhibitors may cause common adverse events (genital mycotic infections, volume depletion) in addition to rare but severe sequela, including euglycemic diabetic ketoacidosis, Fournier’s gangrene, and lower limb amputation. While evidence of CV benefits grows, SGLT2 inhibitor prescribing has lagged, particularly among patients without diabetes. In the U.S., high cost and administrative hurdles may contribute to decreased patient and clinician uptake of this drug class. Future trial results and clinical experience with SGLT2 inhibitors may lead to expanded use and greater uptake among patients with heart failure.

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Distribution and determinants of healthcare costs for self-care behaviours among patients with type 2 diabetes across low-resource communities in Nepal

Dahal,

Rawal,

Ademi

et al. 2024

Discov Health Systems

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Background Type 2 diabetes mellitus (T2DM) is a global public health problem, imposing significant financial burden on its’ management and care. Patients’ self-care behaviours can help to reduce the financial burden on healthcare resources. However, no studies have examined the distribution of healthcare costs related to self-care behaviours in low and lower middle-income countries. Therefore, this study aimed to explore the distribution and associated determinants of healthcare expenses incurred on self-care behaviours among patients with T2DM in low-resource communities in Nepal. Methods We conducted a cross-sectional study, collecting data from 481 patients with T2DM across low-resource communities in the Kavrepalanchok and Nuwakot districts of Nepal. We applied micro-costing with a bottom-up approach to estimate the healthcare costs for 6 month periods. Self-care behaviours were assessed using a self-reported questionnaire. The relationship between healthcare expenses and self-care behaviours was modelled by using a generalised linear model with an identity-link function and 10,000 bootstrapping resampling techniques. Results The average healthcare cost for managing T2DM is US $22.87 per patient for 6 months. Patients who engaged in footcare had the highest total expenses at US $71.98, followed by those who regularly conducted glucose monitoring (US $29.55), met physical activity recommendations (US $23.68), adhered to prescribed medication intake (US $23.59) and adhered to recommended dietary habits (US $22.98). Those patients who met the physical activity guidelines, regularly conducted glucose monitoring, and engaged in footcare had 18%, 32%, and 102% higher expenses respectively, compared to their counterparts. Conclusions Footcare was the most expensive and least practised component of self-care behaviour for managing T2DM, followed by glucose monitoring and physical activity, underscoring the significance of making these behaviours affordable and accessible in diabetes management. This provides valuable insight for decision-makers to prioritise and ensure these behaviours are affordable for patients with diabetes. Graphical Abstract

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Differential Cost-Sharing Undermines Treatment Adherence to Combination Therapy: Evidence from Diabetes Treatment

Cited by 3 publications

References 31 publications

Evaluation of Patient-Oriented Medicines Supply Information on Russian Healthcare Providers’ Websites

Evaluation of Patient-Oriented Medicines Supply Information on Russian Healthcare Providers’ Websites

The Role of Sodium-Glucose Cotransporter-2 Inhibition in Heart Failure with Preserved Ejection Fraction

Distribution and determinants of healthcare costs for self-care behaviours among patients with type 2 diabetes across low-resource communities in Nepal

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