Identifying the Effect of Drug Pricing and Cost Barriers on Adherence

Abstract

Specific Aims: To improve the quality of telecommunication healthcare and Medicare Part D programs by identifying the barriers related to drug costs on patient adherence. The type of prescription medications associated with the Center for Medicare and Medicaid Services’ (CMS) Star Ratings were specifically targeted to identify whether differing rates of adherence was present for patients with or without copays. Methods: A retrospective study was conducted to analyze a sample of non-adherent patients that were enrolled in Medicare Part D insurance and qualified for Medication Therapy Management (MTM) services at SinfoníaRx. Non-adherence was characterized as either no fill or a late fill for chronic conditions (i.e., diabetes, hypertension, hyperlipidemia) during a 180-day period for prescription claims data with a proportion of days covered (PDC) < 80%. Main Results: A dataset of 356 patients was included in the analysis. Demographic data consisted of 231 females and 125 males with marginal differences in characteristics (p = 0.94) and age (p > 0.05). There was no difference between patient adherence with or without a copay (p = 0.10). Subgroup analysis showed that only patients on a statin with a copay exhibited differences in adherence compared to those prescribed an antihyperglycemic or antihypertensive agent (p = 0.01). Conclusions: Patients had similar rates of adherence, independent of monthly copay costs. However, statin medication adherence was found to be inversely related to copayments. Further research using a larger study population to sufficiently power this study is warranted in order to mitigate biases and control confounding factors.