The Role of Gender in Cost-Related Medication Nonadherence Among Patients with Diabetes

Abstract

Under 50% of type 2 diabetic patients achieve the recommended glycemic control. One barrier to glycemic control is patients' cost-related nonadherence to medications. We hypothesize gender differences in medication nonadherence due to costs among diabetic patients. US National Health Interview Survey (2011 to 2014) data yielded 5260 males and 6188 females with diabetes for over a year. We applied 2 analytic methods (A and B below) across multiple outcome measures (1 to 4) of medication nonadherence due to cost. The key independent variable was participant's gender. Across methods and measure, females consistently report significantly higher rates of medication nonadherence due to costs. Pearson's χ2 showed that female patients were more likely to (1) skip medication (13.5%-10.2%; P < .001), take less than prescribed medication (13.9%-10.5%; P < .001), delay filling prescriptions (16.8%-12.5%; P < .001), and ask doctors to prescribe lower-cost alternative medications (31.8%-28.0%; P < .001). Controlling for covariates, logistic regression models found females more likely to skip medication (OR, 1.30; 95% CI, 1.09-1.55), take less than prescribed medication (OR, 1.26; 95%, CI, 1.06-1.50), delay filling prescriptions, (OR, 1.29; 95% CI, 1.11-1.50), and request lower-cost medication (OR, 1.17; 95% CI, 1.04-1.32). Our results report other factors that influence medication adherence, including socioeconomic and health status variables. A significant gender-based disparity exists on cost-related nonadherence of medication among diabetic patients. Health care providers and policy-makers should pay close attention to find ways to address cost-related nonadherence of medication among patients with chronic illness, especially among female patients.