Access and cost-related non-adherence to prescription medications among lupus cases and controls: the Michigan Lupus Epidemiology & Surveillance (MILES) Program

Details

• Alternative Title:
  Arthritis Care Res (Hoboken)
• Personal Author:
  Minhas, Deeba ; Marder, Wendy ; Harlow, Sioban ; Hassett, Afton L. ; Zick, Suzanna M. ; Gordon, Caroline ; Barbour, Kamil E. ; Helmick, Charles G. ; Wang, Lu ; Lee, Jiha ; Padda, Amrita ; McCune, W. Joseph ; Somers, Emily C.
• Description:
  Background:
  
  Medication access and adherence are important determinants of health outcomes. We investigated factors associated with access and cost-related non-adherence to prescriptions in a population-based cohort of systemic lupus erythematosus (SLE) patients and controls.
  
  Methods:
  
  Detailed sociodemographic and prescription data were collected by structured interview in 2014–2015 from participants in the Michigan Lupus Epidemiology & Surveillance (MILES) Cohort. We compared access between cases and frequency-matched controls and examined associated factors in separate multivariable logistic regression models.
  
  Results:
  
  654 participants (462 SLE cases, 192 controls) completed the baseline visit; 584 (89%) were female, 285 (44%) black, and mean age was 53 years. SLE cases and controls reported similar frequencies of being unable to access prescribed medications (12.1% vs 9.4%, respectively; p=NS). SLE patients were twice as likely as controls to report cost-related prescription non-adherence in the preceding 12 months to save money (21.7% vs 10.4%; p=0.001), but also more likely to ask their doctor for lower cost alternatives (23.8% vs 15.6%, p=0.02). Disparities were found in association with income, race and health insurance status, but main findings persisted after adjusting for these and other variables in multivariable models.
  
  Conclusion:
  
  SLE patients were more likely than controls from the general population to report cost-related prescription non-adherence, including skipping doses, taking less medicine and delaying filling prescriptions, yet less than 1 in 4 patients asked providers for lower cost medications. Consideration of medication costs in patient decision-making could provide a meaningful avenue for improving access and adherence to medications.
  
  
• Subjects:
  Access To Care Adult Aged Article Case-Control Studies Cost Savings Drug Costs Drug Substitution Epidemiology Female Health Expenditures Health Services Accessibility Humans Interviews As Topic Lupus Erythematosus, Systemic Male Medication Adherence Michigan Middle Aged Population Surveillance Registries Systemic Lupus Erythematosus

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• Source:
  Arthritis Care Res (Hoboken). 73(11):1561-1567
• Pubmed ID:
  32741110
• Pubmed Central ID:
  PMC9219566
• Document Type:
  Journal Article
• Funding:
  U01 DP003250/DP/NCCDPHP CDC HHSUnited States/ ; UL1RR024986/RR/NCRR NIH HHSUnited States/ ; K01 ES019909/ES/NIEHS NIH HHSUnited States/ ; 1U01 DP006265/CC/CDC HHSUnited States/ ; P30 ES017885/ES/NIEHS NIH HHSUnited States/ ; UL1 TR002240/TR/NCATS NIH HHSUnited States/ ; U01 DP006265/DP/NCCDPHP CDC HHSUnited States/ ; U58 DP001441/DP/NCCDPHP CDC HHSUnited States/ ; U01 DP006489/DP/NCCDPHP CDC HHSUnited States/ ; UL1 RR024986/RR/NCRR NIH HHSUnited States/
• Volume:
  73
• Issue:
  11
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha256:8330e9b0a7a31cc20c1e6e25f90272bb067e6d909ca1df958c709e4215cd5f56
• Download URL:
  https://stacks.cdc.gov/view/cdc/118565/cdc_118565_DS1.pdf
• File Type:
  [PDF - 557.45 KB ]