Cost-related medication nonadherence and cost-saving strategies among Native Hawaiian and Pacific Islander cancer survivors.

Abstract

e18531 Background: Although cost-related medication nonadherence resulting from sequelae of cancer and treatment has been reported in other racial/ethnic populations, little is known about cost-related medication nonadherence among Native Hawaiian and Pacific Islander cancer survivors. This study compared cost-related medication nonadherence among Native Hawaiian and Pacific Islander adults diagnosed with and without cancer and described the strategies cancer survivors used to offset the costs of medications. Methods: Using data from the 2014 Native Hawaiian and Pacific Islander National Health Interview Survey, we compared self-reported cost-related medication nonadherence, shifting spending from basic needs to afford medications, and cost reduction strategies among Native Hawaiian and Pacific Islanders diagnosed with and without cancer. Cancer survivors were those with a history of cancer (excluding nonmelanoma/unknown type of skin cancer). Descriptive statistics and logistic regression models were used to characterize (age, sex, sexual orientation, marital status, household income, educational attainment, health insurance status, comorbidities, self-rated health, activity limitation, and cancer type) and compare these populations. Results: Of 2,593 adults were included in the study, 151 (5.8%) reported a history of cancer, and 2,442 (94.2%) did not. Although 13.6% of cancer survivors and 7.7% without cancer reported cost-related medication nonadherence (p = 0.065), about 9.9% and 11.7% of those with and without cancer, respectively, reported delays in filling a prescription to save money. In addition, about 8.0% and 9.9% of those with and without cancer, respectively, reported taking less medication to save money. In weighted adjusted analyses, the rate of cost-related non-adherence among the two groups was similar, but with some subgroup differences noted by sex and household income. The use of cost reduction strategies was mostly similar among cancer survivors and those without cancer. Conclusions: Cost-related medication nonadherence is common among Native Hawaiian and Pacific Islanders, but appears at similar prevalence among those diagnosed with and without cancer.