Medication Nonadherence in Diabetes (original) (raw)

Cost of medication nonadherence associated with diabetes, hypertension, and dyslipidemia

American Journal of Pharmacy Benefits

objectives: To develop a methodology to estimate the national and state-level annual cost associated with nonadherence to medications for diabetes, hypertension, and dyslipidemia. study Design: Economic cost model. Methods: A review of factors impacting the cost of nonadherence was undertaken. Based on the factors identifi ed in the review, a methodology incorporating information about national and state estimates of current nonadherence rates, health insurance status, disease prevalence and comorbidity, and per patient disease-specifi c adherence-related cost savings was used to estimate the total and per adult national and state-level direct cost of nonadherence in diabetes, hypertension, and dyslipidemia. Results: The total direct national cost of nonadherence for adults diagnosed with diabetes, hypertension, or dyslipidemia was 105.8billion,oranaverageof105.8 billion, or an average of 105.8billion,oranaverageof453 per adult, in 2010. The average peradult nonadherence cost by state was found to vary from 284to284 to 284to634. Conclusions: In the absence of a directly measured national cost of nonadherence across multiple disease states, this estimate updates and refi nes the methodology used to derive indirect estimates. Using a systematic and transparent approach based on information from standard national and state-level data sources, we demonstrate that nonadherence has a signifi cant direct cost in 3 chronic conditions where medication plays an important part in therapy. (Am J Pharm Benefi ts. 2012;4(2):e41-e47) original Research

Cost-Related Nonadherence to Medications Among Patients With Diabetes and Chronic Pain

Diabetes Care, 2009

OBJECTIVE In the face of financial constraints, diabetic patients may forgo prescribed medications, causing negative health effects. This study examined how cost and noncost factors are associated with patterns of cost-related nonadherence to medications (CRN). RESEARCH DESIGN AND METHODS This was a cross-sectional survey of patients using medications for both diabetes and chronic pain (n = 245). Patients reported their income, out-of-pocket medication costs, education level, depressive symptoms, and medication-related beliefs and whether they cut back because of cost on 1) both diabetes and pain medications, 2) diabetes medications only, 3) pain medications only, or 4) neither. Multinomial logistic regression was used to model patients' adjusted odds ratios (AORs) of falling into these four possible categories. RESULTS Of the patients, 9% cut back on medications for both conditions, 13% cut back on diabetes medications alone, and 9% cut back on pain medications alone. Income &l...

Modeling the economic impact of medication adherence in type 2 diabetes: a theoretical approach

2010

Aims: While strong correlations exist between medication adherence and health economic outcomes in type 2 diabetes, current economic analyses do not adequately consider them. We propose a new approach to incorporate adherence in cost-effectiveness analysis. Methods: We describe a theoretical approach to incorporating the effect of adherence when estimating the long-term costs and effectiveness of an antidiabetic medication. This approach was applied in a Markov model which includes common diabetic health states. We compared two treatments using hypothetical patient cohorts: injectable insulin (IDM) and oral (OAD) medications. Two analyses were performed, one which ignored adherence (analysis 1) and one which incorporated it (analysis 2). Results from the two analyses were then compared to explore the extent to which adherence may impact incremental cost-effectiveness ratios. Results: In both analyses, IDM was more costly and more effective than OAD. When adherence was ignored, IDM generated an incremental cost-effectiveness of 12,097perquality−adjustedlife−year(QALY)gainedversusOAD.Incorporationofadherenceresultedinaslightlyhigherratio(12,097 per quality-adjusted life-year (QALY) gained versus OAD. Incorporation of adherence resulted in a slightly higher ratio (12,097perquality−adjustedlife−year(QALY)gainedversusOAD.Incorporationofadherenceresultedinaslightlyhigherratio(16,241/QALY). This increase was primarily due to better adherence with OAD than with IDM, and the higher direct medical costs for IDM. Conclusions: Incorporating medication adherence into economic analyses can meaningfully influence the estimated cost-effectiveness of type 2 diabetes treatments, and should therefore be considered in health care decision-making. Future work on the impact of adherence on health economic outcomes, and validation of different approaches to modeling adherence, is warranted.

Does medication adherence lead to lower healthcare expenses for patients with diabetes?

The American journal of managed care, 2013

To examine the relationship between medication adherence and healthcare outcomes and expenses and to investigate whether the duration of type 2 diabetes mellitus (T2DM) has a role in the aforementioned relationship. Health insurance claims data under a universal coverage system in Taiwan. Seven years of longitudinal analysis was performed to examine the association between medication adherence of oral antihyperglycemic drugs and outcomes among patients with newly diagnosed T2DM. Generalized estimating equations were conducted to assess the temporal relationship while controlling for unobserved characteristics of patients. Better medication adherence was associated with decreased hospitalization and emergency department (ED) visits for diabetes or related conditions. The results also revealed that medication adherence was negatively associated with the expenses of hospitalization and ED visits for diabetes or related conditions, but medication adherence was positively associated with...

Impact of Medication Adherence on Hospitalization Risk and Healthcare Cost

Medical Care, 2005

The objective of this study was to evaluate the impact of medication adherence on healthcare utilization and cost for 4 chronic conditions that are major drivers of drug spending: diabetes, hypertension, hypercholesterolemia, and congestive heart failure. Research Design: The authors conducted a retrospective cohort observation of patients who were continuously enrolled in medical and prescription benefit plans from June 1997 through May 1999. Patients were identified for disease-specific analysis based on claims for outpatient, emergency room, or inpatient services during the first 12 months of the study. Using an integrated analysis of administrative claims data, medical and drug utilization were measured during the 12-month period after patient identification. Medication adherence was defined by days' supply of maintenance medications for each condition. Patients: The study consisted of a population-based sample of 137,277 patients under age 65. Measures: Disease-related and all-cause medical costs, drug costs, and hospitalization risk were measured. Using regression analysis, these measures were modeled at varying levels of medication adherence. Results: For diabetes and hypercholesterolemia, a high level of medication adherence was associated with lower disease-related medical costs. For these conditions, higher medication costs were more than offset by medical cost reductions, producing a net reduction in overall healthcare costs. For diabetes, hypercholesterolemia, and hypertension, cost offsets were observed for all-cause medical costs at high levels of medication adherence. For all 4 conditions, hospitalization rates were significantly lower for patients with high medication adherence. Conclusions: For some chronic conditions, increased drug utilization can provide a net economic return when it is driven by improved adherence with guidelines-based therapy.

The nonadherence to prescriptions among type 2 diabetes patients, and its determining factors

2024

The aim is to clarify the prevalence of nonadherence to antidiabetic therapies among type 2 diabetes mellitus (T2DM) patients and identify its causes. Methods: A three-part questionnaire (general background, Knowledge-Attitude-Practice section, and nonadherence reasons) was developed. In total 324 diabetic patients were surveyed via telephone. The evaluation of patient adherence included both direct questions on adherence and a summary of patient responses to nonadherence comments. The analysis was performed on StataCorp Stata 14.2, and included descriptive analysis, simple and multivariate logistic regression. Findings: Among the sociodemographic variables, age group, work level, and alcohol consumption may influence medication adherence. The comorbidity status of patients was also of relevance. Both variables had stronger relationships with adherence to anti-diabetic treatments compared to those with no comorbidities or no additional medicines. A strength of the study is that it addresses various medical diseases and attitudes about them, as well as a wide range of causes for non-adherence to non-diabetic medications.