Cost-related medication nonadherence and cost-saving strategies used by elderly Medicare cancer survivors.
Cost-related medication nonadherence and cost-saving strategies used by elderly Medicare cancer survivors.
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DOI：
10.1007/s11764-011-0188-4
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发表时间：
2011-12
期刊：
影响因子：
--
通讯作者：
Ross-Degnan D
中科院分区：
文献类型：
--
作者：
Nekhlyudov L;Madden J;Graves AJ;Zhang F;Soumerai SB;Ross-Degnan D
比较患有癌症和不患有癌症的老年联邦医疗保险参与者中与成本相关的药物不遵守情况，并描述癌症幸存者用来抵消药物成本的策略。使用2005年联邦医疗保险当前受益人调查和联邦医疗保险索赔，我们比较了患有和不患有癌症的老年受益人中自我报告的成本相关用药不依从性(CRN)、在支付药品的基本需求上的支出减少以及降低成本的策略。描述性统计和Logistic回归模型被用来描述和比较这些人群。在具有全国代表性的9818名非制度化老年医疗保险参保人中，1392人(14%)根据医疗保险申请被归类为癌症幸存者。癌症幸存者年龄更大，受教育程度更高，更有可能是男性和非西班牙裔，更有可能有多种并存疾病，健康状况较差，以及雇主支付的药物保险。10%的癌症幸存者和11%的非癌症患者报告了慢性肾衰；患有癌症和非癌症的患者中，分别约有6%和9%(p=0.004)报告说，为了抵消药物费用，他们在基本需求上的支出减少了。与没有报告CRN的癌症幸存者相比，报告CRN的癌症幸存者的收入较低(62.2%比48.6%，p=0.033)，更有可能是非裔美国人(13.0%比6.4%，p=0.033)，并且拥有非雇主为基础的药物保险(p=0.002)。在调整后的分析中，两组之间的CRN相似，但在性别和癌症类型方面有一些亚组差异。在癌症幸存者和非癌症患者中，使用降低成本策略的情况基本相似。与费用相关的用药不坚持用药在老年联邦医疗保险受益人中很常见，但在患有和不患有癌症的人中似乎相似。
To compare cost-related medication nonadherence among elderly Medicare enrollees with and without cancer, and to describe the strategies cancer survivors used to offset the costs of medications. Using the 2005 Medicare Current Beneficiary Survey and Medicare claims, we compared self-reported cost-related medication nonadherence (CRN), spending less on basic needs to afford medicines, and cost-reduction strategies among elderly beneficiaries with and without cancer. Descriptive statistics and logistic regression models were used to characterize and compare these populations. In a nationally representative sample of 9818 non-institutionalized elderly Medicare enrollees, 1392 (14%) were classified as cancer survivors based on Medicare claims. Cancer survivors were older, more highly educated, more likely to be male and non-Hispanic, and more likely to have multiple co-morbidities, poorer health status, and employer-paid medication coverage. While 10% of cancer survivors and 11% without cancer reported CRN; about 6% and 9% (p=0.004) of those with and without cancer, respectively, reported spending less on basic needs to offset the costs of medications. Cancer survivors who reported CRN (n=143) had lower income (62.2% versus 48.6%, p=0.11), and were more likely to be African-American (13.0% versus 6.4%, p=0.033), and have non-employer-based medication insurance (p=0.002) compared to those who did not report CRN. In adjusted analyses, CRN among the two groups was similar, but with some subgroup differences noted by gender and cancer type. Use of cost-reduction strategies was mostly similar among cancer survivors and those without cancer. Cost-related medication nonadherence medication is common among elderly Medicare beneficiaries, but appears to be similar among those with and without cancer.
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影响因子：
45.3
作者：
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