National Healthcare Quality and Disparities Report
Latest available findings on quality of and access to health care
Data
- Data Infographics
- Data Visualizations
- Data Tools
- Data Innovations
- All-Payer Claims Database
- Healthcare Cost and Utilization Project (HCUP)
- Medical Expenditure Panel Survey (MEPS)
- AHRQ Quality Indicator Tools for Data Analytics
- State Snapshots
- United States Health Information Knowledgebase (USHIK)
- Data Sources Available from AHRQ
Search All Research Studies
Topics
- Behavioral Health (1)
- Cancer (1)
- Cancer: Prostate Cancer (1)
- Chronic Conditions (2)
- Dementia (1)
- Diabetes (5)
- (-) Healthcare Costs (11)
- Healthcare Delivery (1)
- Health Insurance (3)
- Human Immunodeficiency Virus (HIV) (1)
- Medical Expenditure Panel Survey (MEPS) (1)
- Medicare (1)
- (-) Medication (11)
- Neurological Disorders (1)
- (-) Patient Adherence/Compliance (11)
AHRQ Research Studies
Sign up: AHRQ Research Studies Email updates
Research Studies is a compilation of published research articles funded by AHRQ or authored by AHRQ researchers.
Results
1 to 11 of 11 Research Studies DisplayedCaram MEV, Oerline MK, Dusetzina S
Adherence and out-of-pocket costs among Medicare beneficiaries who are prescribed oral targeted therapies for advanced prostate cancer.
The authors investigated coping and material measures of the financial hardship of abiraterone and enzalutamide among patients with advanced prostate cancer with Medicare Part D coverage. They found substantial variations in the adherence rate and out-of-pocket payments, with sociodemographic patient and regional factors found to be associated with both aspects.
AHRQ-funded; HS025707.
Citation: Caram MEV, Oerline MK, Dusetzina S .
Adherence and out-of-pocket costs among Medicare beneficiaries who are prescribed oral targeted therapies for advanced prostate cancer.
Cancer 2020 Dec 1;126(23):5050-59. doi: 10.1002/cncr.33176..
Keywords: Patient Adherence/Compliance, Medicare, Cancer: Prostate Cancer, Cancer, Medication, Healthcare Costs
Flory JH, Mushlin AI
Effect of cost and formulation on persistence and adherence to initial metformin therapy for type 2 diabetes.
This paper studied whether persistence and adherence to initial release (IR) metformin was at the same levels as extended release (ER) metform for adults with type 2 diabetes. A study was conducted using merged de-identified claims data from commercial insurance carriers in the US from 2012 to 2016. The cohort used was identified as patients aged 18 years or older who filled an initial 30-day prescription for metformin monotherapy with a baseline type 2 diabetes diagnosis, at least 1 year of baseline and follow-up data, and no prior antidiabetes drug use. “Persistence” was defined as at least one metformin prescription claim during the 6-12 month window after the initial prescription. “Adherence” was defined as the percentage of days for which the patient had filled sufficient prescriptions to be taking it “as prescribed”. The final study population was 81,406 patients, with 78% having commercial insurance, 19% Medicare Advantage, and 2.5% were dual-eligible for Medicare and Medicare. Persistence was slightly higher for ER metformin than for IR metformin, as was adherence and adequate adherence (80% or more). Despite the slightly higher cost, initial use of ER metformin was associated with better adherence.
AHRQ-funded; HS023898.
Citation: Flory JH, Mushlin AI .
Effect of cost and formulation on persistence and adherence to initial metformin therapy for type 2 diabetes.
Diabetes Care 2020 Jun;43(6):e66-e67. doi: 10.2337/dc19-2426..
Keywords: Diabetes, Chronic Conditions, Healthcare Costs, Medication, Patient Adherence/Compliance
Reynolds EL, JF JF, Banerjee M
Association of out-of-pocket costs on adherence to common neurologic medications.
The objective of this training was to determine the association between out-of-pocket costs and medication adherence in 3 common neurologic diseases. The investigators concluded that higher out-of-pocket costs were associated with lower medication adherence in 3 common neurologic conditions. The investigators also observed racial/ethnic disparities and recommended that minority populations receive additional focus in future intervention efforts to improve adherence.
AHRQ-funded; HS017690; HS022258.
Citation: Reynolds EL, JF JF, Banerjee M .
Association of out-of-pocket costs on adherence to common neurologic medications.
Neurology 2020 Mar 31;94(13):e1415-e26. doi: 10.1212/wnl.0000000000009039..
Keywords: Medication, Healthcare Costs, Patient Adherence/Compliance, Neurological Disorders, Dementia
Kang H, Lobo JM, Kim S
Cost-related medication non-adherence among U.S. adults with diabetes.
The purpose of this study is to examine factors that affect cost-related medication non-adherence (CRN), defined as taking medication less than as prescribed because of cost, among adults with diabetes and to determine their relative contribution in explaining CRN. Among other results, the study found that Insulin users had 1.24 times higher risk of CRN compared to those not on insulin.
AHRQ-funded; HS018542.
Citation: Kang H, Lobo JM, Kim S .
Cost-related medication non-adherence among U.S. adults with diabetes.
Diabetes Res Clin Pract 2018 Sep;143:24-33. doi: 10.1016/j.diabres.2018.06.016..
Keywords: Diabetes, Healthcare Costs, Medication, Patient Adherence/Compliance
Karter AJ, Parker MM, Solomon MD
Effect of out-of-pocket cost on medication initiation, adherence, and persistence among patients with type 2 diabetes: the Diabetes Study of Northern California (DISTANCE).
This study estimated the effect of out-of-pocket (OOP) cost on nonadherence to classes of cardiometabolic medications among patients with diabetes. Primary nonadherence (never dispensed) increased monotonically with OOP cost after adjusting for demographics, neighborhood socioeconomic status, Medicare, medical financial assistance, OOP maximum, deductibles, mail order pharmacy incentive and use, drug type, generic or brand, day's supply, and comorbidity index.
AHRQ-funded; HS022408.
Citation: Karter AJ, Parker MM, Solomon MD .
Effect of out-of-pocket cost on medication initiation, adherence, and persistence among patients with type 2 diabetes: the Diabetes Study of Northern California (DISTANCE).
Health Serv Res 2018 Apr;53(2):1227-47. doi: 10.1111/1475-6773.12700.
.
.
Keywords: Diabetes, Healthcare Costs, Health Insurance, Medication, Patient Adherence/Compliance
Belenky N, Pence BW, Cole SR
Associations between Medicare Part D and out-of-pocket spending, HIV viral load, adherence, and ADAP use in dual eligibles with HIV.
This study estimated the effect of Medicare part D on self-reported out-of-pocket prescription drug spending, AIDS Drug Assistance Program (ADAP) use, antiretroviral adherence, and HIV viral load (VL) suppression among dual eligibles with HIV. It concluded that part D was associated with increased out-of-pocket spending, although the increased spending did not seem to compromise antiretroviral therapy adherence or HIV VL suppression.
AHRQ-funded; HS024858; HS000032.
Citation: Belenky N, Pence BW, Cole SR .
Associations between Medicare Part D and out-of-pocket spending, HIV viral load, adherence, and ADAP use in dual eligibles with HIV.
Med Care 2018 Jan;56(1):47-53. doi: 10.1097/mlr.0000000000000843.
.
.
Keywords: Healthcare Costs, Human Immunodeficiency Virus (HIV), Medication, Patient Adherence/Compliance
Yeung K, Basu A, Marcum ZA
Impact of a value-based formulary in three chronic disease cohorts.
This study assessed the impact of a value based formulary (VBF) on medication adherence and patient and health plan expenditures on 3 chronic disease states: diabetes, hypertension, and hyperlipidemia. The investigators measured medication expenditures from member, health plan, and member-plus-health plan (overall) perspectives and medication adherence as proportion of days covered. They conducted an exploratory analysis of medication utilization classifying medications according to whether co-payments moved up or down in the year following VBF implementation.
AHRQ-funded; HS022982.
Citation: Yeung K, Basu A, Marcum ZA .
Impact of a value-based formulary in three chronic disease cohorts.
Am J Manag Care 2017 Mar; 23(3 Suppl):S46-s53..
Keywords: Chronic Conditions, Health Insurance, Patient Adherence/Compliance, Medication, Healthcare Costs
Lyles CR, Seligman HK, Parker MM
Financial strain and medication adherence among diabetes patients in an integrated health care delivery system: The Diabetes Study of Northern California (DISTANCE).
The researchers examined self-reported financial strain in relation to pharmacy utilization adherence data. Their analysis of survey, administrative, and electronic medical data from Kaiser Permanente Northern California found that 8 percent and 9 percent reported general and medication-specific financial strain. In adjusted models, general strain was significantly associated with primary nonadherence and refilling late and medication-specific strain was ssociated with primary nonadherence.
AHRQ-funded; HS022408.
Citation: Lyles CR, Seligman HK, Parker MM .
Financial strain and medication adherence among diabetes patients in an integrated health care delivery system: The Diabetes Study of Northern California (DISTANCE).
Health Serv Res 2016 Apr;51(2):610-24. doi: 10.1111/1475-6773.12346.
.
.
Keywords: Diabetes, Medication, Patient Adherence/Compliance, Healthcare Costs, Healthcare Delivery
Miller GE, Sarpong EM, Hill SC
AHRQ Author: Miller GE, Sarpong EM, Hill SC
Does increased adherence to medications change health care financial burdens for adults with diabetes?
The aim of the present study was to investigate increased out-of-pocket drug costs and financial burdens of achieving adherence to oral antidiabetic medications and medications for prevalent comorbidities. The researchers found that the mean simulated additional out-of-pocket drug costs of achieving adherence were $310 for uninsured adults treated for diabetes. These additional drug costs would increase the percentage of uninsured adults with financial burden.
AHRQ-authored.
Citation: Miller GE, Sarpong EM, Hill SC .
Does increased adherence to medications change health care financial burdens for adults with diabetes?
J Diabetes 2015 Nov;7(6):872-80. doi: 10.1111/1753-0407.12292..
Keywords: Medical Expenditure Panel Survey (MEPS), Healthcare Costs, Diabetes, Patient Adherence/Compliance, Medication
Predmore ZS, Mattke S, Horvitz-Lennon M
Improving antipsychotic adherence among patients with schizophrenia: savings for states.
The authors presented findings of an analysis conducted to quantify the potential net savings to state budgets from interventions to improve adherence to antipsychotic drugs among patients with schizophrenia. Their financial model estimated an annual cost of $21.4 billion (in 2013 dollars) to Medicaid programs and other state agencies for people with schizophrenia. They concluded that better adherence could yield annual net savings of $3.28 billion to states and recommended that states consider interventions shown to increase medication adherence in this patient group.
AHRQ-funded; HS000029.
Citation: Predmore ZS, Mattke S, Horvitz-Lennon M .
Improving antipsychotic adherence among patients with schizophrenia: savings for states.
Psychiatr Serv 2015 Apr;66(4):343-5. doi: 10.1176/appi.ps.201400506.
.
.
Keywords: Healthcare Costs, Medication, Behavioral Health, Patient Adherence/Compliance
Starner CI, Alexander GC, Bowen K
Specialty drug coupons lower out-of-pocket costs and may improve adherence at the risk of increasing premiums.
The investigators examined insurers' role in maintaining the affordability and accessibility of specialty drugs while maximizing their value. They found that drug coupons accounted for $21.2 million of patients' $35.3 million annual out-of-pocket costs. In the vast majority of cases, coupons reduced monthly cost sharing to less than $250, a point at which patients were far less likely to abandon therapy with biologic anti-inflammatory drugs or with drugs for multiple sclerosis. They highlighted that, by reducing cost sharing, coupons may also circumvent efforts to encourage patients to use the most cost-effective drugs.
AHRQ-funded; HS018960.
Citation: Starner CI, Alexander GC, Bowen K .
Specialty drug coupons lower out-of-pocket costs and may improve adherence at the risk of increasing premiums.
Health Aff 2014 Oct;33(10):1761-9. doi: 10.1377/hlthaff.2014.0497.
.
.
Keywords: Healthcare Costs, Health Insurance, Medication, Patient Adherence/Compliance