Recent Trends in Cost-Related Medication Nonadherence Among Cancer Survivors in the United States

J Manag Care Spec Pharm. 2018 Jan;24(1):56-64. doi: 10.18553/jmcp.2018.24.1.56.

Abstract

Background: Cancer survivors avoid necessary medications due to costs.

Objective: To estimate the prevalence of cost-related medication non-adherence (CRN) by age and insurance status over a number of years in a national sample of U.S. cancer survivors.

Methods: Using the 1999-2012 National Health Interview Survey, we examined the prevalence and correlates of self-reported CRN, that is, patient-reported inability to afford prescribed medications within the past 12 months, resulting in nonadherence among cancer survivors. Descriptive statistics and multivariate logistic regression models were used to identify time trends in CRN among cancer survivors.

Results: In a nationally representative sample of 20,517 cancer survivors from 1999 to 2012, 1,788 (8.7%) survivors reported CRN, representing approximately 436,498 individuals nationally. CRN increased significantly from 11.8% (1999-2005) to 16.9% (2006-2012) among younger cancer survivors (P < 0.001). Among young cancer survivors (aged 45-64 years), the uninsurance rate was higher for those reporting CRN in the years 2006-2012 (48.5%) than in the earlier period (42.5%; P = 0.043). Among older cancer survivors, insurance coverage through Medicare only was lower for individuals reporting CRN in the years 2006-2012 (5.8%) than in the earlier period (7.8%; P = 0.0210). In adjusted models, younger cancer survivors without health insurance were more likely to report CRN than those with supplemental private insurance with Medicare, and older cancer survivors with Medicare only were more likely to report CRN than those with supplemental private insurance with Medicare.

Conclusions: Increasing trends in CRN were evident among younger cancer survivors.

Disclosures: No external funding was received for this work. The authors have no conflicts of interest to report. Study concept and design were contributed by Lee, along with Khan and Salloum. Lee collected the data, and data interpretation was performed by Lee, Khan, and Salloum. The manuscript was written primarily by Lee, with assistance from Khan and Salloum, and revised by Lee, Khan, and Salloum.

MeSH terms

  • Adult
  • Age Factors
  • Aged
  • Antineoplastic Agents / economics
  • Antineoplastic Agents / therapeutic use*
  • Cancer Survivors / statistics & numerical data*
  • Drug Costs*
  • Female
  • Humans
  • Insurance Coverage / statistics & numerical data
  • Male
  • Medicare Part D / statistics & numerical data
  • Medication Adherence / statistics & numerical data*
  • Middle Aged
  • Neoplasms / drug therapy*
  • Neoplasms / economics
  • United States

Substances

  • Antineoplastic Agents