Effect of Medication Copayment on Adherence and Discontinuation in Medicare Beneficiaries with Type 2 Diabetes: A Retrospective Administrative Claims Database Analysis
| العنوان: | Effect of Medication Copayment on Adherence and Discontinuation in Medicare Beneficiaries with Type 2 Diabetes: A Retrospective Administrative Claims Database Analysis |
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| المؤلفون: | Bruce Stuart, Liou Xu, Manjiri Pawaskar, Swapnil Rajpathak, Gary A. Puckrein, Yuexin Tang |
| المصدر: | Diabetes Therapy |
| بيانات النشر: | Springer Healthcare, 2018. |
| سنة النشر: | 2018 |
| مصطلحات موضوعية: | medicine.medical_specialty, Endocrinology, Diabetes and Metabolism, 030209 endocrinology & metabolism, Type 2 diabetes, Copayment, Lower risk, Medicare, 03 medical and health sciences, 0302 clinical medicine, Diabetes mellitus, Internal medicine, Internal Medicine, medicine, 030212 general & internal medicine, health care economics and organizations, Original Research, business.industry, Incidence (epidemiology), medicine.disease, Discontinuation, Adherence, Cohort, business, Cohort study |
| الوصف: | Introduction Nonadherence to antihyperglycemic agents (AHAs) increases the incidence of morbidity and mortality, as well as healthcare-related costs, in patients with type 2 diabetes (T2D). This study examined the association between medication copayment and adherence and discontinuation among elderly patients with T2D who use generic versus branded AHAs. Methods A retrospective, observational cohort study used Medicare administrative claims data (index period: 1 June 2012 to 31 December 2013). Drug copayments were measured as the copayment of the index medication for a 30-day supply after patients met their plan deductible. Patients were stratified into a branded or generic cohort based on the index medication. Adherence was measured by the proportion of days covered (≥ 80%) and discontinuation by a treatment gap of > 60 days in 10 months during the follow-up period. Poisson regressions were conducted for medication adherence and discontinuation, while controlling for demographic, clinical, and comorbid conditions. Results Overall, 160,250 patients on AHA monotherapy were included in the analysis; 131,594 (82%) were prescribed a generic and 28,656 (18%) a branded AHA with a mean copay of $6 and $41, respectively. Increases in copayment increased nonadherence and discontinuation for branded medications but not for generic AHA medications. In both cohorts, elderly patients (≥ 75 years of age) had a lower risk of nonadherence and discontinuation. Black patients had a higher risk of nonadherence or discontinuing medication. Patients having more frequent inpatient, emergency room, and/or physician visits were at higher risk of nonadherence or discontinuing therapy in the branded and generic cohorts (P |
| اللغة: | English |
| تدمد: | 1869-6961 1869-6953 |
| URL الوصول: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::9944411ee1512057bfd85b5cc65a4e8f http://europepmc.org/articles/PMC6167308 |
| حقوق: | OPEN |
| رقم الأكسشن: | edsair.doi.dedup.....9944411ee1512057bfd85b5cc65a4e8f |
| قاعدة البيانات: | OpenAIRE |
Find this article in full text from Springer Verlag. | تدمد: | 18696961 18696953 |
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