N S Donnenberg1, I Hernandez2, D P Normolle3. 1. Univ of Pittsburgh, School of Pharmacy, Department of Pharmacy and Therapeutics, Pittsburgh, PA, USA. Electronic address: nsd15@pitt.edu. 2. Univ of California San Diego (UCSD), Skaggs School of Pharmacy, Department of Pharmaceutical Sciences, Division of Clinical Pharmacy, La Jolla, CA, USA. 3. Univ of Pittsburgh, Graduate School of Public Health, Department of Biostatistics, Pittsburgh, PA, USA.
Abstract
BACKGROUND: Prescription affordability is a key component of healthcare accessibility and a determinant of health outcomes. Prior studies indicate that up to 1 in 4 Americans report difficulty affording prescriptions. OBJECTIVE(S): This study aims to identify factors associated with cost-based prescription refusal. METHODS: We identified 17,869 study participants from the 2017 National Health Interview Survey who had been prescribed at least one medication in the past 12 months. The outcome was defined as inability to afford at least one prescription medication. Covariates included demographic data, medical history, and social attitudes. Logistic regression models were constructed to identify predictors of cost-based prescription refusal. RESULTS: Among 8223 study participants, 8.1% reported the inability to afford at least one prescription medication in the past 12 months. Twenty-seven covariates were correlated with prescription unaffordability, and 8 were selected by the LASSO: Income (Odds ratio (OR) 0.55), Concerned About Bills (OR 2.0), Emergency Department Visits past 12 months (OR 1.33), Dissatisfaction with Medical Care (OR 1.3), Seeking Insurance Through the Health Insurance Marketplace (OR 1.26), Feeling Sad Most of the Time (OR 1.24), History of Asthma (OR 1.26) and History of Diabetes (OR 1.24). CONCLUSIONS: Prescription unaffordability remains a significant public health problem and is more common among low-income individuals and patients with, chronic medical conditions.
BACKGROUND: Prescription affordability is a key component of healthcare accessibility and a determinant of health outcomes. Prior studies indicate that up to 1 in 4 Americans report difficulty affording prescriptions. OBJECTIVE(S): This study aims to identify factors associated with cost-based prescription refusal. METHODS: We identified 17,869 study participants from the 2017 National Health Interview Survey who had been prescribed at least one medication in the past 12 months. The outcome was defined as inability to afford at least one prescription medication. Covariates included demographic data, medical history, and social attitudes. Logistic regression models were constructed to identify predictors of cost-based prescription refusal. RESULTS: Among 8223 study participants, 8.1% reported the inability to afford at least one prescription medication in the past 12 months. Twenty-seven covariates were correlated with prescription unaffordability, and 8 were selected by the LASSO: Income (Odds ratio (OR) 0.55), Concerned About Bills (OR 2.0), Emergency Department Visits past 12 months (OR 1.33), Dissatisfaction with Medical Care (OR 1.3), Seeking Insurance Through the Health Insurance Marketplace (OR 1.26), Feeling Sad Most of the Time (OR 1.24), History of Asthma (OR 1.26) and History of Diabetes (OR 1.24). CONCLUSIONS: Prescription unaffordability remains a significant public health problem and is more common among low-income individuals and patients with, chronic medical conditions.
Authors: Juan Carlos Cardet; Margee Louisias; Tonya S King; Mario Castro; Christopher D Codispoti; Ryan Dunn; Linda Engle; B Louise Giles; Fernando Holguin; John J Lima; Dayna Long; Njira Lugogo; Sharmilee Nyenhuis; Victor E Ortega; Sima Ramratnam; Michael E Wechsler; Elliot Israel; Wanda Phipatanakul Journal: J Allergy Clin Immunol Date: 2017-05-20 Impact factor: 10.793
Authors: M Christopher Roebuck; J Samantha Dougherty; Robert Kaestner; Laura M Miller Journal: Health Aff (Millwood) Date: 2015-09 Impact factor: 6.301
Authors: Aaron S Kesselheim; Krista F Huybrechts; Niteesh K Choudhry; Lisa A Fulchino; Danielle L Isaman; Mary K Kowal; Troyen A Brennan Journal: Am J Public Health Date: 2015-02 Impact factor: 9.308
Authors: M Sue Kirkman; Megan T Rowan-Martin; Rebecca Levin; Vivian A Fonseca; Julie A Schmittdiel; William H Herman; Ronald E Aubert Journal: Diabetes Care Date: 2015-01-08 Impact factor: 19.112