ArticleJCO oncology practice2022
Cost-Related Medication Nonadherence and Patient Cost Responsibility for Rural and Urban Cancer Survivors.
Article in JCO oncology practice, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.
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Who cites it
7 citing papers in PubMed.
- Patient-centered burdens and economic outcomes among patients who are veterans, people with intellectual and developmental disabilities, and people living in rural areas and their caregivers: a scoping review.Frontiers in public health · 2026Article
- Providers' and Survivors' Perspectives on Affordability Challenges for Gastrointestinal Cancer Treatment in Two Low Socioeconomic Status States of the Southern United States.Cancer medicine · 2025Article
- Understanding the financial cost of cancer clinical trial participation.Cancer medicine · 2024Article
- Article
- Associations between healthcare costs and care experiences among older adults with and without cancer.Journal of geriatric oncology · 2023Article
- Assessing a Pharmacist-Enabled Intervention to Improve Adherence to Medication for Hypertension, Dyslipidemia, and Chronic Venous Circulation Disorders in Greece.Patient preference and adherence · 2023Article
- Growing the Next Generation of Oncology Researchers and Oncologists.JCO oncology practice · 2022Article
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Authors and funding
7 authors.
Funding
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Abstract
purposeThe relationship between out-of-pocket spending and cost-related medication nonadherence among older rural- and urban-dwelling cancer survivors is not well understood.
methodsThis retrospective cohort study used the Surveillance, Epidemiology, and End Results Program, Medicare claims, and the Consumer Assessment of Healthcare Providers and Systems survey linked data resource linked data (2007-2015) to investigate the relationship between cancer survivors' cost responsibility in the year before and after report of delaying or not filling a prescription medication because of cost in the past 6 months (cost-related medication nonadherence). Secondary exposures and outcomes included Medicare spending and utilization. Generalized linear models assessed bidirectional relationships between cost-related medication nonadherence, spending, and utilization. Effects of residence were assessed via interaction terms.
resultsOf 6,591 older cancer survivors, 13% reported cost-related medication nonadherence. Survivors were a median 8 years (interquartile range, 4.5-12.5 years) from their cancer diagnosis, 15% were dually Medicare/Medicaid-eligible, and prostate (40%) and breast (32%) cancer survivors were most prevalent. With every $500 USD increase in patient cost responsibility, risk of cost-related medication nonadherence increased by 3% (risk ratio, 1.03; 95% CI, 1.02 to 1.04). After report of cost-related medication nonadherence, patient cost responsibility was 22% higher (95% CI, 1.11 to 1.32) compared with those not reporting nonadherence, amounting to $523 USD (95% CI, $430 USD to $630 USD). Medicare spending and utilization were also higher before and after report of cost-related nonadherence versus none. For survivors residing in rural (18%) and urban (82%) areas, residence did not modify adherence or cost outcomes.
conclusionA bidirectional relationship exists between patient cost responsibility and cost-related medication nonadherence. Interventions reducing urban- and rural-dwelling survivor health care costs and cost-related adherence barriers are needed.
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