Medication Non-adherence is Associated with Increased Medical Health Care Costs
- 1.3k Downloads
Background and Aims Non-adherence to 5-aminosalicylic acid (5-ASA) is associated with adverse outcomes; however, no data exist regarding cost and non-adherence. Our aim was to determine the association between adherence to maintenance therapy and healthcare costs. Methods Patients in the Maryland CareFirst BlueCross BlueShield program with a follow-up of more than 1 month who had been prescribed at least one 5-ASA preparation during the period 1 January 2002 to 31 December 2004 were included. Non-adherence was defined as failure to refill a prescription claim, and a medication possession ratio was calculated. Generalized linear models were built to determine the association between annual average cost per patient. Results A total of 4313 patients were included, although only 57% were adherent with their index medication. The mean medication possession ratio ranged from 72% for Azulfidine to 82% for generic sulfasalazine. A twofold difference in gastroenterology-related inpatient cost in non-adherent versus adherent patients (22.8% vs 11.7%, P < 0.01) was observed. Non-adherence also incurred more costs for outpatient services and office visits. In multivariate analysis, patients who were persistent with their medications incurred 12.5% lower medical costs (P = 0.03). Conclusions Adherence remains low over time. Non-adherence was associated with higher health care costs for both in- and outpatient settings. Patients need educated regarding non-adherence and increased costs.
KeywordsUlcerative colitis Mesalamine Health care cost Medication adherence
- 6.World HO (2003) Adherence to long-term therapies. Evidence for action. Available at http://www.who.int/chronic conditions/adherencereport/en/ Accessed August 2006
- 8.Morris AD, Brennan GM, MacDonald TM, Donnan PT (2000) Population-based adherence to prescribed medication in type 2 diabetes: a cause for concern. Diabetes 49(Suppl 1):A76Google Scholar
- 10.Kaiser Family Foundation. Maryland: Distribution of non-elderly 0–64 by insurance status, state data 2001–2002, US 2002. State Health Facts Online, statehealthfacts.kff.org (accessed on March 10, 2006)Google Scholar
- 16.Shaya FT, El Khoury AC, Wong W et al (2006) Persistence with pharmacotherapy for gastrointestinal disease: associated costs of health care. P&T 31(11):657–665Google Scholar