Abstract
We aimed to assess the risk factors for cost-related medication non-adherence (CRN) among older patients with cancer in the United States. We used data from the 2010 Health and Retirement Study (HRS) to assess risk factors for CRN including age, insurance coverage, nursing home residence, functional limitations, and frequency of hospitalization among old patients with cancer. CRN was self-reported. We conducted a multivariate regression analysis to assess the effect of each risk factor. 293 (9.9%) of 2,953 older patients (50+ years) cancer patients reported CRN. Those who reported CRN were more likely to be younger, women, African American, and Hispanics. Compared to those with Medicare, those with no health insurance coverage were 97% more likely to report CRN. High number in limitation in activities of daily living and hospitalization significantly increased risk for CRN. Sicker cancer patients were more likely to report CRN. Lack of health insurance may have prevented the cancer patients from receiving optimal care. Together, these results suggest that expanding insurance coverage and improving insurance benefit design for cancer patients is likely to decrease CRN and improve outcomes.
Highlights
Access barrier to effective medication treatment has been a persistent issue for millions of older Americans
Those who reported cost-related medication nonadherence (CRN) were more likely to be younger, female, African-Americans, and Hispanic. Those who reported CRN were more likely not having any type of insurance coverage, or with Medicaid
We found that there were about 9.9% of cancer patients reported CRN, and those who reported CRN were more likely to be female, African American,or Hispanic
Summary
Access barrier to effective medication treatment has been a persistent issue for millions of older Americans. Minority status, and lack of health insurance have been identified as risk factors for CRN, and there is a persistent gender difference in CRN among cancer survivors [9,10] In these patients, medication non-adherence can significantly reduce the effectiveness of care, placing them at an increased risk of declining health and incurring significant downstream costs. Little is known about the other factors associated with CRN in cancer patients, metrics of the high burden of disease, including limitations in functional status, frequency of hospitalization, residence in a nursing home, and comparative risk among various public and private health insurance plans. Our aim was to assess variation in CRN with a broad set of risk factors for cancer patients over the age of 50 using a nationally representative dataset
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