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Cancer History, Health Insurance Coverage, and Cost-Related Medication Nonadherence and Medication Cost-Coping Strategies in the United States.
- Source :
-
Value in health : the journal of the International Society for Pharmacoeconomics and Outcomes Research [Value Health] 2019 Jul; Vol. 22 (7), pp. 762-767. Date of Electronic Publication: 2019 May 16. - Publication Year :
- 2019
-
Abstract
- Objectives: To evaluate the relationship between cancer history and cost-related medication nonadherence (CRN) as well as cost-coping strategies, by health insurance coverage.<br />Methods: We used the 2013 to 2016 National Health Interview Survey to identify adults aged 18 to 64 years with (n = 3599) and without (n = 56 909) a cancer history. Cost-related changes in medication use included (1) CRN, measured as skipping, taking less, or delaying medication because of cost, and (2) cost-coping strategies, measured as requesting lower cost medication or using alternative therapies to save money. Separate multivariable logistic regressions were used to calculate the adjusted odds ratios (AORs) of CRN and cost-coping strategies associated with cancer history, stratified by insurance.<br />Results: Cancer survivors were more likely than adults without a cancer history to report CRN (AOR 1.26; 95% confidence interval [CI] 1.10-1.43) and cost-coping strategies (AOR 1.10; 95% CI 0.99-1.19). Among the privately insured, the difference in CRN by cancer history was the greatest among those enrolled in high-deductible health plans (HDHPs) without health savings accounts (HSAs) (AOR 1.78; 95% CI 1.30-2.44). Among adults with HDHP and HSA, cancer survivors were less likely to report cost-coping strategies (AOR 0.62; 95% CI 0.42-0.90). Regardless of cancer history, CRN and cost-coping strategies were the highest for those uninsured, enrolled in HDHP without HSA, and without prescription drug coverage under their health plan (all P<.001).<br />Conclusions: Cancer survivors are prone to CRN and more likely to use cost-coping strategies. Expanding options for health insurance coverage, use of HSAs for those with HDHP, and enhanced prescription drug coverage may effectively address CRN.<br /> (Copyright © 2019 ISPOR–The Professional Society for Health Economics and Outcomes Research. Published by Elsevier Inc. All rights reserved.)
- Subjects :
- Adolescent
Adult
Cost Savings
Deductibles and Coinsurance economics
Drug Substitution economics
Drugs, Generic economics
Drugs, Generic therapeutic use
Female
Health Care Surveys
Health Knowledge, Attitudes, Practice
Humans
Male
Medical Savings Accounts
Middle Aged
Neoplasms epidemiology
Neoplasms psychology
Time Factors
United States epidemiology
Young Adult
Antineoplastic Agents economics
Antineoplastic Agents therapeutic use
Cancer Survivors psychology
Health Expenditures
Insurance Coverage economics
Insurance, Health economics
Medication Adherence
Neoplasms drug therapy
Neoplasms economics
Subjects
Details
- Language :
- English
- ISSN :
- 1524-4733
- Volume :
- 22
- Issue :
- 7
- Database :
- MEDLINE
- Journal :
- Value in health : the journal of the International Society for Pharmacoeconomics and Outcomes Research
- Publication Type :
- Academic Journal
- Accession number :
- 31277821
- Full Text :
- https://doi.org/10.1016/j.jval.2019.01.015