Effect of Medication Copayment on Adherence and Discontinuation in Medicare Beneficiaries with Type 2 Diabetes: A Retrospective Administrative Claims Database Analysis

Diabetes Therapy : Research, Treatment and Education of Diabetes and Related Disorders
Manjiri D PawaskarBruce Stuart

Abstract

Nonadherence to antihyperglycemic agents (AHAs) increases the incidence of morbidity and mortality, as well as healthcare-related costs, in patients with type 2 diabetes (T2D). This study examined the association between medication copayment and adherence and discontinuation among elderly patients with T2D who use generic versus branded AHAs. A retrospective, observational cohort study used Medicare administrative claims data (index period: 1 June 2012 to 31 December 2013). Drug copayments were measured as the copayment of the index medication for a 30-day supply after patients met their plan deductible. Patients were stratified into a branded or generic cohort based on the index medication. Adherence was measured by the proportion of days covered (≥ 80%) and discontinuation by a treatment gap of > 60 days in 10 months during the follow-up period. Poisson regressions were conducted for medication adherence and discontinuation, while controlling for demographic, clinical, and comorbid conditions. Overall, 160,250 patients on AHA monotherapy were included in the analysis; 131,594 (82%) were prescribed a generic and 28,656 (18%) a branded AHA with a mean copay of $6 and $41, respectively. Increases in copayment increased nonadhere...Continue Reading

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Citations

Jan 30, 2019·Current Opinion in Endocrinology, Diabetes, and Obesity·Samir Malkani
Jul 26, 2019·The Annals of Pharmacotherapy·Bruce A WardenSergio Fazio
Dec 14, 2019·BMC Health Services Research·John P McHughAmal N Trivedi
Aug 29, 2020·Journal of Managed Care & Specialty Pharmacy·Ralph WardMulugeta Gebregziabher
Sep 8, 2021·Osteoporosis International : a Journal Established As Result of Cooperation Between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA·Friederike ThomasiusGeneviève Gauthier

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