Shou-Hsia Cheng1, Chi-Chen Chen, Chin-Hsiao Tseng. 1. Institute of Health Policy and Management, College of Public Health, National Taiwan University, 17, Xu-Zhou Rd, Taipei, Taiwan, 100. E-mail: shcheng@ntu.edu.tw.
Abstract
OBJECTIVES: To examine the relationship between medication adherence and healthcare outcomes and expenses and to investigate whether the duration of type 2 diabetes mellitus (T2DM) has a role in the aforementioned relationship. DATA SOURCE/STUDY SETTING: Health insurance claims data under a universal coverage system in Taiwan. STUDY DESIGN: Seven years of longitudinal analysis was performed to examine the association between medication adherence of oral antihyperglycemic drugs and outcomes among patients with newly diagnosed T2DM. Generalized estimating equations were conducted to assess the temporal relationship while controlling for unobserved characteristics of patients. RESULTS: Better medication adherence was associated with decreased hospitalization and emergency department (ED) visits for diabetes or related conditions. The results also revealed that medication adherence was negatively associated with the expenses of hospitalization and ED visits for diabetes or related conditions, but medication adherence was positively associated with patients' total healthcare expenses. However, the adherence-related differences in total healthcare expenses began to decrease 5 years after the time of diabetes onset. CONCLUSIONS: Adherence to medication can improve healthcare outcomes but is associated with higher total healthcare expenses, especially during the years immediately following the onset of diabetes. Long-term follow-up is needed for further investigation.
OBJECTIVES: To examine the relationship between medication adherence and healthcare outcomes and expenses and to investigate whether the duration of type 2 diabetes mellitus (T2DM) has a role in the aforementioned relationship. DATA SOURCE/STUDY SETTING: Health insurance claims data under a universal coverage system in Taiwan. STUDY DESIGN: Seven years of longitudinal analysis was performed to examine the association between medication adherence of oral antihyperglycemic drugs and outcomes among patients with newly diagnosed T2DM. Generalized estimating equations were conducted to assess the temporal relationship while controlling for unobserved characteristics of patients. RESULTS: Better medication adherence was associated with decreased hospitalization and emergency department (ED) visits for diabetes or related conditions. The results also revealed that medication adherence was negatively associated with the expenses of hospitalization and ED visits for diabetes or related conditions, but medication adherence was positively associated with patients' total healthcare expenses. However, the adherence-related differences in total healthcare expenses began to decrease 5 years after the time of diabetes onset. CONCLUSIONS: Adherence to medication can improve healthcare outcomes but is associated with higher total healthcare expenses, especially during the years immediately following the onset of diabetes. Long-term follow-up is needed for further investigation.