Observational studyJournal of general internal medicine2022
Association Between High Deductible Health Plans and Cost-Related Non-adherence to Medications Among Americans with Diabetes: an Observational Study.
Observational study in Journal of general internal medicine, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers, 1 of them a synthesis that pooled it.
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The trial behind it
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Who cites it
9 citing papers in PubMed, 1 synthesis or guideline pooled it, 12 citations in OpenAlex.
- Financial Toxicity in Diabetes: The State of What We Know.Current diabetes reports · 2025Pooled it
- Evaluating Financial Incentives as a Tool to Increase Medication Adherence for Patients with Type 2 Diabetes Mellitus: A Systematic Review and Meta-Analysis.Diabetes therapy : research, treatment and education of diabetes and related disorders · 2025Article
- The Association Between Cost-Related Insulin Rationing and Health Care Utilization in U.S. Adults With Diabetes.Diabetes care · 2025Article
- Trends and Inequalities in Diabetes-Related Complications Among U.S. Adults, 2000-2020.Diabetes care · 2025Article
- Delayed treatment initiation of oral anticoagulants among Medicare patients with atrial fibrillation.American heart journal plus : cardiology research and practice · 2024Article
- Association of High-Deductible Health Plans With Health Care Use and Costs for Patients With Cardiovascular Disease.Journal of the American Heart Association · 2023Article
- Factors Associated With Adherence to First-line Antiviral Therapy Among Commercially Insured Patients With Chronic Hepatitis B.Open forum infectious diseases · 2023Article
- The Association Between Cost-Related Non-Adherence Behaviors and Diabetes Outcomes.Journal of the American Board of Family Medicine : JABFM · 2023Article
- Equity in Medical Care for People Living With Diabetes.Diabetes spectrum : a publication of the American Diabetes Association · 2022Article
Corrections and comments
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Authors and funding
9 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundFor people with diabetes, adherence to prescribed medications is essential. However, the rising prevalence of high-deductible health plans (HDHPs), and prices of diabetes medications such as insulin, could deter adherence.
objectiveTo assess the impact of HDHP on cost-related medication non-adherence (CRN) among non-elderly adults with diabetes in the US.
designRepeated cross-sectional survey.
settingNational Health Interview Survey, 2011-2018.
participantsA total of 7469 privately insured adults ages 18-64 with diabetes who were prescribed medications and enrolled in a HDHP or a traditional commercial health plan (TCP). MAIN MEASURES: Self-reported measures of CRN were compared between enrollees in HDHPs and TCPs overall and among the subset using insulin. Analyses were adjusted for demographic and clinical characteristics using multivariable linear regression models. KEY
resultsHDHP enrollees were more likely than TCP enrollees to not fill a prescription (13.4% vs 9.9%; adjusted percentage point difference (AD) 3.4 [95% CI 1.5 to 5.4]); skip medication doses (11.4% vs 8.5%; AD 2.8 [CI 1.0 to 4.7]); take less medication (11.1% vs 8.8%; AD 2.3 [CI 0.5 to 4.0]); delay filling a prescription to save money (14.4% vs 10.8%; AD 3.0 [CI 1.1 to 4.9]); and to have any form of CRN (20.4% vs 15.5%; AD 4.4 [CI 2.2 to 6.7]). Among those taking insulin, HDHP enrollees were more likely to have any CRN (25.1% vs 18.9%; AD 5.9 [CI 1.1 to 10.8]).
conclusionHDHPs are associated with greater CRN among people with diabetes, particularly those prescribed insulin. For people with diabetes, enrollment in non-HDHPs might reduce CRN to prescribed medications.
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