Prescription drug coverage satisfaction and medication nonadherence among Medicare beneficiaries with cancer

ABSTRACT

Background

Medication nonadherence among older patients with cancer can have profound health consequences. This study examines the association between prescription drug coverage satisfaction and medication nonadherence among Medicare beneficiaries with cancer.

Methods

We analyzed the 2017 Medicare Current Beneficiary Survey Public Use File of beneficiaries aged ≥65 years with reported non-skin cancer (n = 806). Beneficiaries were considered to have medication nonadherence if they reported: skipping doses, taking smaller doses than prescribed, or delaying or not filling a prescription because of cost. A survey-weighted logistic model, adjusted for covariates, was conducted to examine the association between prescription drug coverage satisfaction and medication nonadherence.

Results

Of study beneficiaries with cancer, 14.7% reported medication nonadherence. Higher proportions of beneficiaries with medication nonadherence were dissatisfied with the amount paid for medications (33.2% vs. 11.0%, p < 0.001) and the medications included on formulary (29.5% vs 5.2%, p < 0.001). In the adjusted analysis, the risk for medication nonadherence was higher among those who were dissatisfied with the amount paid for medications (OR = 2.22; p = 0.050) and the medications included on formulary (OR = 5.03; p = 0.005).

Conclusions

Strategic mitigation of these barriers is essential to improving health outcomes in this at-risk population.

KEYWORDS:

• Cancer
• drug coverage satisfaction
• medication nonadherence
• medicare

Declaration of interest

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

Reviewer disclosures

Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Author contributions

All authors were involved in the data interpretation and revising the manuscript. C Park and B Ng lead the conception and design, as well as statistical analyses of the paper. C Silverman and C Baek drafted the paper and revised the manuscript for intellectual content. C Park and B Ng provided essential advice on the focus of the analysis and methodology. All authors jointly made the decision to submit the manuscript for publication. All authors agree for the final version of the manuscript to be published.

Supplementary material

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Additional information

Funding

The author(s) reported there is no funding associated with the work featured in this article.