Insurance status and patient behavior with asthma medications.

Few studies have measured patients' asthma medication compliance, medication costs, and insurance status. We used a questionnaire assessing details of asthma, medications used, patient costs, and methods used to reduce medication costs to assess these factors. Patients in outpatient clinics, emergency rooms, and inpatient units of two urban Chicago hospitals who had a history of asthma and an age of 18 years or older were eligible for the study. Two hundred subjects completed the questionnaire of which 54 (27%) were self-pay/uninsured, 54 (27%) had public aid, and 92 (46%) had insurance. The public aid group had a significantly higher rate of emergency room services. Eighty-four (42% of all participants) had no costs, including no copayment to obtain their antiasthma medications. Self-pay/uninsured patients more commonly reported delaying filling a prescription, failure to fill a prescription, and taking less than recommended doses than the other two groups. Self-pay/uninsured patients also more commonly reported choosing their pharmacy on the basis of medication costs. Participants with public aid reported their physicians inquired about insurance status, estimated medication costs, advised measures to reduce costs, and gave them free medication samples less often than the other two groups. In conclusion, patients report different methods to reduce their medication costs that vary according to their insurance status. Advice on methods to reduce medication costs and being supplied with medication samples also varied by insurance status according to participants' report.