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Cost-Related Medication Underuse Among Chronically III Adults: the Treatments People Forgo, How Often, and Who Is at Risk
Abstract
Objectives. We sought information about the cost-related underuse of medications—which medications are underused, by whom, and how often. Methods. Chronically ill adults were asked to identify how often they underused prescription medication for 16 health conditions because of the cost. Results. Eighteen percent of respondents cut back on medication use owing to cost in the previous year, and 14% used less medication at least monthly. Although rates of underuse varied substantially across treatments, prescription coverage and out-of-pocket costs were determinants of underuse across medication types. Conclusions. Many chronically ill adults frequently cut back on medications owing to cost. Patients are selective about the treatments they forgo. Out-of-pocket costs and inadequate prescription coverage may lead to adherence problems for many important medication types.
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“In a study of patients with chronic disease, two-thirds of those who reported not taking medications as prescribed due to cost never shared this with their physician [30,31].”
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Schokkaert, E., Steel, J. S., & de Voorde, C. V. (2017) · Applied Health Economics and Health Policy · doi:10.1007/s40258-017-0331-0 · Cited by 49
Johnell, K., Lindström, M., Sundquist, J., Eriksson, C. C.-G., & Merlo, J. (2006) · BMC Public Health · doi:10.1186/1471-2458-6-52 · Cited by 48
Prescription drug co-payments and cost-related medication underuse
Wagner, T. H., Heisler, M., & Piette, J. D. (2008) · Health Economics Policy and Law · doi:10.1017/s1744133107004380 · Cited by 47
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Metadata
- Authors
- Piette, J. D., Heisler, M., & Wagner, T. H.
- Affiliations
- United States Department of Veterans Affairs (US)
- Venue
- American Journal of Public Health
- Publisher
- American Public Health Association
- Published
- 2004-10
- Volume
- 94
- Issue
- 10
- Pages
- 1782-1787
- ISSN
- 0090-0036 (ISSN-L)
- 1541-0048
- OpenAlex
- W2161088956
- Cited by
- 349
- References
- 17
- Citations by year
- 2026: 3 · 2025: 9 · 2024: 2 · 2023: 7 · 2022: 15 · 2021: 15 · 2020: 17 · 2019: 18 · 2018: 17 · 2017: 16 · 2016: 22 · 2015: 22 · 2014: 18 · 2013: 19 · 2012: 19
- FWCI
- 38.69
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- American Journal of Public Health (publishedVersion)
- PubMed (publishedVersion)
- DigitalGeorgetown (Georgetown University Library) (submittedVersion)
- Funders
- Health Services Research and Development
- Topics
- Social Sciences › Economics, Econometrics and Finance › Economics and Econometrics › Economic and Financial Impacts of Cancer
- Health Sciences › Medicine › Family Practice › Medication Adherence and Compliance
- Social Sciences › Economics, Econometrics and Finance › Economics and Econometrics › Healthcare Policy and Management
- Keywords
- prescription drug costs, out-of-pocket costs, medication adherence, chronic disease, health care costs
- MeSH terms
- Aged, Chronic Disease, Female, Financing, Personal, Health Services Research, Humans, Male, Middle Aged, Patient Compliance, Drug Prescriptions, Socioeconomic Factors, United States, Drug Costs, Cost of Illness, Drug Utilization Review
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