Effect of medication adherence on long-term all-cause-mortality and hospitalization for cardiovascular disease in 65,067 newly diagnosed type 2 diabetes patients

Kim, Yeon Yong; Lee, Jin Seok; Kang, Hee Jin; Park, Sang Min

doi:10.1038/s41598-018-30740-y

Cited by 48 publications

(67 citation statements)

References 34 publications

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“…In another health care database study from Sweden, lower refill adherence to lipid‐lowering medications resulted in higher CVD mortality among patients with type 2 DM 28 . Similarly, in newly diagnosed type 2 DM patients, lower anti‐diabetic medication adherence has been associated with higher long‐term all‐cause mortality 29 . In the current study, the difference in mortality was insignificant between the FDC and FEC groups may be explained by the low event rates in both groups, which could be attributed to the limited sample size, limited 4‐year follow‐up period, and the primary preventive nature of the intervention.…”

Section: Discussionmentioning

confidence: 97%

Fixed‐dose combination of amlodipine and atorvastatin improves clinical outcomes in patients with concomitant hypertension and dyslipidemia

Lin

Tung

Hsiao

et al. 2020

J of Clinical Hypertension

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Section: Discussionmentioning

confidence: 97%

Fixed‐dose combination of amlodipine and atorvastatin improves clinical outcomes in patients with concomitant hypertension and dyslipidemia

Lin

Tung

Hsiao

et al. 2020

J of Clinical Hypertension

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“…40 Cost-related medications non-adherence is associated with higher rate of all-cause mortality and cardiovascular complications among newly diagnosed type 2 diabetes mellitus patients. 41 Although more adherent patients incur higher pharmacy costs, these are generally offset by savings in other areas such as costs of hospital admissions and physicians' visits. 42 Thus, the patients have to use NPH, as the basal insulin component.…”

Section: Discussionmentioning

confidence: 99%

Affordability of Medication Therapy in Diabetic Patients: A Scenario-Based Assessment in Iran’s Health System Context

Zarei

Peymani

Moradi

et al. 2020

Int J Health Policy Manag

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Background: Diabetes imposes an enormous burden on patients, families, societies, and healthcare systems. Determining the affordability of medications is an important complicated and vague task, especially in low- and middle-income countries (LMICs). This study aimed to assess the affordability of diabetes medication therapy in Iran’s health system. Methods: This paper presents a scenario-based assessment of the affordability of all registered anti-diabetes medications in Iran in 2017. To this end, 4 medication therapy scenarios were defined as mono, dual, triple, and insulin therapy in accordance with the existing guidelines and clinicians’ opinions. Then the affordability ratio of each treatment scenario was determined for type 1 and type 2 diabetes drawing on the World Health Organization (WHO)/Health Action International (HAI) Methodology. If the affordability ratio for treatment schedules was more than 1, the patients’ out-of-pocket (OOP) expenses exceeded the lowest-paid unskilled government worker (LPGW)’ wage per day, and the treatment was labelled as non-affordable. Results: The results revealed that the mono, dual, and triple (non-insulin) medication therapies in type 2 diabetes were affordable, despite an increase in the dosage or a switch from the monotherapy to the combination therapy of oral medications. However, some treatment scenarios in the triple therapy, including oral plus insulin and some insulin only therapies, were proved to be non-affordable. In type 1 diabetes, only insulin glulisine, detemir, and lispro were non-affordable in monotherapy. Regarding the combination therapy, only isophane insulin with aspart or regular insulin were affordable treatments. Conclusion: Although oral medication therapies were documented to be affordable, insulin therapy, with current coverage conditions, for patients with lowest paid wages and those receiving even less is unaffordable and a major barrier to treatment; hence, policy-maker should consider targeting and more financial protection policies to improve the affordability of insulin therapies among this group of patients.

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“…The failure to effectively use prescription medicines can lead to worse health status and higher costs to the healthcare system [5]. Non-adherence worsens health outcomes and increases the risk of mortality and hospitalization [6,7]. Greater use of medical services and productivity losses are also consequences of from medication non-adherence, which places a signi cant cost burden on healthcare systems [8,9].…”

Section: Introductionmentioning

confidence: 99%

Who suffers from pharmaceutical poverty and what are their needs? Evidence from a Spanish region.

Rubio-Valera¹,

Marqués-Ercilla

Peñarrubia-María

et al. 2020

Preprint

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Background Pharmaceutical poverty occurs when a patient cannot afford the cost of prescribed medication and/or medical products. Non-profit organisations are covering the cost of medication to those patients in some contexts. The aim of the study was to describe the population of beneficiaries of the PB, a non-governmental organization which provides free of charge access to medicines, and their utilization pattern of medicines and healthcare products. Methods This was an observational study using PB beneficiary data collected between November 2017 and December 2018 in Catalonia. The Catalan Health Service provided information from the general population. A descriptive analysis of the beneficiaries’ characteristics was conducted and compared to general population. Results The beneficiaries (N = 1206) were mainly adults with a low level of education, unemployed, with functional disability and with ≥ 1 children. Compared with the general population, the beneficiaries were older, had a lower level of education, showed a higher prevalence of functional disability, were less likely to be Spanish, and more likely to be divorced and unemployed. The beneficiaries were polymedicated and most were using medication related to the nervous (79%), musculo-skeletal (68%) and cardiovascular system (56%) and alimentary tract and metabolism (68%). Almost 19% of beneficiaries used healthcare products. Female beneficiaries were older and more likely to be divorced or widowed, employed and with children. Compared to men, women were more likely to use medicines for pain and mental disorders. The paediatric group used medications for severe, chronic conditions (heart diseases, autoimmune diseases, conduct disorders and attention deficit hyperactivity disorder). Conclusions Patients with severe, chronic and disabling conditions are affected by pharmaceutical poverty. While the system of co-payment remains unchanged, physicians and paediatricians should explore economic barriers to treatment and direct their patients to resources that help to cover the cost of treatment.

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Effect of medication adherence on long-term all-cause-mortality and hospitalization for cardiovascular disease in 65,067 newly diagnosed type 2 diabetes patients

Cited by 48 publications

References 34 publications

Fixed‐dose combination of amlodipine and atorvastatin improves clinical outcomes in patients with concomitant hypertension and dyslipidemia

Fixed‐dose combination of amlodipine and atorvastatin improves clinical outcomes in patients with concomitant hypertension and dyslipidemia

Affordability of Medication Therapy in Diabetic Patients: A Scenario-Based Assessment in Iran’s Health System Context

Who suffers from pharmaceutical poverty and what are their needs? Evidence from a Spanish region.

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