ArticleArchives of internal medicine2009
Cost sharing and the initiation of drug therapy for the chronically ill.
Article in Archives of internal medicine, 2009. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 20 papers, 1 of them a synthesis that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
20 citing papers in PubMed, 1 synthesis or guideline pooled it, 61 citations in OpenAlex.
- Pooled it
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- Prevalence and predictors of primary nonadherence to medications prescribed in primary care.CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne · 2023Article
- Out-of-Pocket Spending for Thumb Carpometacarpal Arthritis: Capitation Matters.Hand (New York, N.Y.) · 2021Article
- The Economic Burden of Out-of-Pocket Expenses for Plastic Surgery Procedures.Plastic and reconstructive surgery · 2020Article
- Medicaid Eligibility Expansions May Address Gaps In Access To Diabetes Medications.Health affairs (Project Hope) · 2018Article
- Poverty, Transportation Access, and Medication Nonadherence.Pediatrics · 2018Observational
- Effect of Out-of-Pocket Cost on Medication Initiation, Adherence, and Persistence among Patients with Type 2 Diabetes: The Diabetes Study of Northern California (DISTANCE).Health services research · 2018Observational
- Medication Nonadherence: The Role of Cost, Community, and Individual Factors.Health services research · 2017Article
- Quality of Antiepileptic Treatment Among Older Medicare Beneficiaries With Epilepsy: A Retrospective Claims Data Analysis.Medical care · 2017Article
- The association between adherence to cardiovascular medications and healthcare utilization.The European journal of health economics : HEPAC : health economics in prevention and care · 2016Article
- Using the Knowledge Base of Health Services Research to Redefine Health Care Systems.Journal of general internal medicine · 2015Review
- Evolving Patient Compliance Trends: Integrating Clinical, Insurance, and Extrapolated Socioeconomic Data.AMIA ... Annual Symposium proceedings. AMIA Symposium · 2015Article
- Experiences addressing health-related financial challenges with disease management among African American women with asthma.The Journal of asthma : official journal of the Association for the Care of Asthma · 2014Article
- Confounding in the association of proton pump inhibitor use with risk of community-acquired pneumonia.Journal of general internal medicine · 2013Article
- Exenatide therapy and the risk of pancreatitis and pancreatic cancer in a privately insured population.Diabetes technology & therapeutics · 2012Article
- Cost sharing, family health care burden, and the use of specialty drugs for rheumatoid arthritis.Health services research · 2010Article
- Primary medication non-adherence: analysis of 195,930 electronic prescriptions.Journal of general internal medicine · 2010Article
- Primary non-adherence of medications: lifting the veil on prescription-filling behaviors.Journal of general internal medicine · 2010Article
- Health care reform and equity: promise, pitfalls, and prescriptions.Annals of family medicineArticle
Corrections and comments
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Authors and funding
4 authors at 1 institution in 1 country.
Funding
Abstract
backgroundIncreased cost sharing reduces utilization of prescription drugs, but little evidence demonstrates how this reduction occurs or the factors associated with price sensitivity.
methodsWe conducted a retrospective cohort study of older adults with employer-provided drug coverage from 1997 to 2002 from 31 different health plans. We measured the time until initiation of medical therapy for 17 183 patients with newly diagnosed hypertension, diabetes, or hypercholesterolemia.
resultsFor all study conditions, higher copayments were associated with delayed initiation of therapy. In survival models, doubling copayments resulted in large reductions in the predicted proportion of patients initiating pharmacotherapy at 1 and 5 years after diagnosis: for hypertension, 54.8% vs 39.9% at 1 year and 81.6% vs 66.2% at 5 years (P < .001); for hypercholesterolemia, 40.2% vs 31.1% at 1 year and 64.3% vs 53.8% at 5 years (P < .002); and for diabetes, 45.8% vs 40.0% at 1 year and 69.3% vs 62.9% at 5 years (P < .04). However, patients' rate of initiation and sensitivity to copayments strongly depended on their prior experience with prescription drugs. Those without prior drug use (26.1%, 10.4%, and 12.9%) initiated later (833, >1170, and >1402 days later in median time until initiation) and were far more price sensitive (increase of 34.5%, 20.1%, and 27.2% remaining untreated after 5 years when copayments doubled) than those with a history of drug use among patients with newly diagnosed hypertension, hypercholesterolemia, and diabetes, respectively. These results were robust to a wide range of sensitivity analyses.
conclusionsHigh cost sharing delays the initiation of drug therapy for patients newly diagnosed with chronic disease. This effect is greater among patients who lack experience with prescription drugs. Policy makers and physicians should consider the effects of benefits design on patient behavior to encourage the adoption of necessary care.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.