PURPOSE: To evaluate the effect of patient cost-sharing on oral diabetes medication adherence and glycemic control. DESIGN: Retrospective observational study. METHODOLOGY: Medical and pharmacy claims from a managed care plan and electronic medical records (EMR) from a large physician organization in Oregon were used to identify a cohort with diabetes. Medication adherence and mean patient cost share was obtained from claims. Glycosylated hemoglobin (A(1c)) values were obtained from an EMR database. PRINCIPAL FINDINGS: Lower mean cost share for patients was associated with higher medication adherence. Each $5 increase in patient cost share resulted in a 15 percent decrease in the adjusted odds of being adherent and a 0.1 percentage point increase in A(1c). CONCLUSION: Increased medication cost share resulted in a decrease in adherence and poorer glycemic control. Employers and insurers should consider the potential consequences of increased medication cost share on diabetes-related outcomes and health care costs.
PURPOSE: To evaluate the effect of patient cost-sharing on oral diabetes medication adherence and glycemic control. DESIGN: Retrospective observational study. METHODOLOGY: Medical and pharmacy claims from a managed care plan and electronic medical records (EMR) from a large physician organization in Oregon were used to identify a cohort with diabetes. Medication adherence and mean patient cost share was obtained from claims. Glycosylated hemoglobin (A(1c)) values were obtained from an EMR database. PRINCIPAL FINDINGS: Lower mean cost share for patients was associated with higher medication adherence. Each $5 increase in patient cost share resulted in a 15 percent decrease in the adjusted odds of being adherent and a 0.1 percentage point increase in A(1c). CONCLUSION: Increased medication cost share resulted in a decrease in adherence and poorer glycemic control. Employers and insurers should consider the potential consequences of increased medication cost share on diabetes-related outcomes and health care costs.
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