Role of health insurance coverage in women's access to prescription medicines.
OBJECTIVE
To examine the effects of health insurance coverage and other factors on access to prescription medicines for non-elderly women ages 18-64.


METHODS
Based on a nationally representative telephone survey of adult women in the United States, this study uses multiple logistic regression to determine the factors significantly associated with cost barriers among non-elderly women. The sample for the study includes 1,177 women ages 18-64 who use >or=1 prescription drug on a regular basis. Cost barriers are defined as not filling a prescription or skipping or splitting doses owing to cost. A composite variable of income and health insurance was created to examine the role of insurance in mitigating barriers for women of different income levels. Descriptive analyses report the share of subgroups of women who have faced any of these cost barriers, and logistic regression analyses were used to examine the role of health insurance, income, and other factors in predicting financial access to prescribed medications.


RESULTS
Over half (54%) of non-elderly women reported that they were taking a prescription medicine on a regular basis, and nearly one third (32%) of these women reported experiencing >or=1 affordability barrier in the prior year and had to either forgo or delay a prescription and/or reduce dosages to make medicines last longer because of costs. Uninsured women had the highest odds of facing a cost barrier, regardless of income level. Low-income, uninsured women were nearly 7 times as likely to face a cost barrier to prescription drugs, compared with higher income women with insurance. Even uninsured women with incomes >or=200% of the federal poverty level had 5 times the odds of facing a prescription medicine cost barrier, and low-income, insured women experienced 2 times the odds of a prescription medicine cost barrier, compared with their higher income, insured counterparts.


CONCLUSIONS
Lack of health insurance coverage was significantly associated with experiencing cost barriers, regardless of income level, underscoring the critical role that insurance coverage plays in protecting women from out-of-pocket costs and for accessing prescription medicines. Limiting out-of-pocket spending is also important for low-income women who have insurance, because even minimal costs can act as barriers for this group.
Henry J. Kaiser Family Foundation, Menlo Park, California 94025, USA. ushar@kff.org
Usha R
UR
Ranji
Roberta
R
Wyn
Alina
A
Salganicoff
Hongjian
H
Yu
D000328:Adult; D001294:Attitude to Health; D005260:Female; D006297:Health Services Accessibility / Q000191:economics / Q000706:statistics & numerical data*; D006301:Health Services Needs and Demand / Q000191:economics / Q000706:statistics & numerical data*; D006304:Health Status; D006801:Humans; D007356:Insurance, Pharmaceutical Services / Q000191:economics / Q000706:statistics & numerical data*; D016015:Logistic Models; D017057:Medically Uninsured / Q000706:statistics & numerical data*; D008875:Middle Aged; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data*; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires; D014481:United States / Q000453:epidemiology; D016387:Women's Health / Q000191:economics*; D014932:Women's Health Services / Q000706:statistics & numerical data