The Effects of Health Plan Copayments on Adherence to Oral Diabetes Medication and Health Resource Utilization

Colombi, Alberto M.; Yu‐Isenberg, Kristina; Priest, Julie

doi:10.1097/jom.0b013e31816ed011

Cited by 45 publications

(57 citation statements)

References 11 publications

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“…Numerous researchers have identified characteristics associated with refill adherence, [19][20][21][22][23][24][25][26][27][28][29][30] but few have determined characteristics associated with primary non-adherence. 10,13,31 We determined characteristics associated with an increased risk of primary non-adherence and identified differences by therapeutic indication, but found no strongly associated characteristics.…”

Section: Discussionmentioning

confidence: 99%

Characteristics of Patients with Primary Non-adherence to Medications for Hypertension, Diabetes, and Lipid Disorders

et al. 2011

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Section: Discussionmentioning

confidence: 99%

Characteristics of Patients with Primary Non-adherence to Medications for Hypertension, Diabetes, and Lipid Disorders

et al. 2011

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“…• Direct and indirect medication-related costs that patients have to bear (e.g., copayments, waiting times, long journeys to reach the doctor) are the most important health care-related factors [21][22][23][24]. • Sociodemographic factors play only a small part [25,26].…”

Section: Introductionmentioning

confidence: 99%

Toward Identifying the Causes and Combinations of Causes Increasing the Risks of Nonadherence to Medical Regimens: Combined Results of Two German Self-Report Surveys

2011

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“…[18][19][20][21][22][23][24] Limitations Administrative claims data utilized for this study included paid claims only and cannot identify the provision of medications or therapies by providers for which members did not use their pharmacy benefit. This limitation may specifically impact the pre-index smoking cessation treatment patterns that were observed, since NRT is available OOP and may not be covered by a member's pharmacy benefit.…”

Section: ■■ Conclusionmentioning

confidence: 99%

Association of Out-of-Pocket Pharmacy Costs with Adherence to Varenicline

Suehs¹,

Davis²,

Galaznik³

et al. 2014

JMCP

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BACKGROUND: Varenicline, a nicotinic acetylcholine receptor partial agonist, is a pharmacotherapy indicated for smoking cessation treatment. To date, no research has examined the relationship between out-of-pocket (OOP) expense and varenicline adherence among Medicare beneficiaries.OBJECTIVES: To (a) characterize medication utilization patterns of varenicline among Medicare members newly initiated on varenicline and (b) examine the relationship between member OOP expense and varenicline medication adherence.METHODS: In this retrospective cohort study, pharmacy claims data were used to identify Medicare Advantage Prescription Drug Plan (MAPD) members newly initiated on varenicline. Demographic and clinical characteristics, varenicline medication utilization patterns, and pharmacy costs (total and varenicline-specific) were determined for members included in the study. Varenicline adherence was measured by calculating the proportion of days covered (PDC) over a period of 84 days (12 weeks) after initiation. Multiple regression analysis was used to examine the relationship between varenicline OOP cost and varenicline medication utilization, while controlling for sociodemographic characteristics, clinical factors, and nonvarenicline pharmacy costs.RESULTS: A total of 15,452 MAPD members were included in the analysis. Mean (SD) subject age was 62.6 (10.0) years; 21.1% (n = 3,256) were dual eligible; and 33.0% (n = 5,106) received a low-income subsidy. Mean (SD) initial varenicline treatment episode duration was 50.8 (37.8) days, with a mean (SD) varenicline days' supply of 47.8 (32.6) obtained by members during the initial treatment episode. Mean (SD) PDC was 0.51 (0.24), and 14.9% (n = 2,302) of members were classified as adherent to treatment (PDC ≥ 0.80). Greater varenicline OOP expense was significantly associated with lower PDC (regression coefficient = -0.058, P < 0.001) and significantly associated with lower odds of receiving a refill for varenicline (odds ratio 0.594, 95% CI: 0.540-0.655, P < 0.001).CONCLUSIONS: Among Medicare beneficiaries newly initiated on varenicline, medication adherence was suboptimal, and greater OOP cost was associated with lower adherence and lower odds of refilling varenicline.

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The Effects of Health Plan Copayments on Adherence to Oral Diabetes Medication and Health Resource Utilization

Abstract: High copayments were associated with lower adherence to oral diabetes medications for all patients and higher total health care costs for patients less than 65.

Cited by 45 publications

References 11 publications

Characteristics of Patients with Primary Non-adherence to Medications for Hypertension, Diabetes, and Lipid Disorders

Characteristics of Patients with Primary Non-adherence to Medications for Hypertension, Diabetes, and Lipid Disorders

Toward Identifying the Causes and Combinations of Causes Increasing the Risks of Nonadherence to Medical Regimens: Combined Results of Two German Self-Report Surveys

Association of Out-of-Pocket Pharmacy Costs with Adherence to Varenicline

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