title: Does medication adherence lead to lower healthcare expenses for patients with diabetes?
abstract: OBJECTIVE
  To examine the relationship between medication adherence and healthcare outcomes and expenses and to investigate whether the duration of type 2 diabetes mellitus (T2DM) has a role in the aforementioned relationship.
  
  
  METHODS
  Health insurance claims data under a universal coverage system in Taiwan.
  
  
  METHODS
  Seven years of longitudinal analysis was performed to examine the association between medication adherence of oral antihyperglycemic drugs and outcomes among patients with newly diagnosed T2DM. Generalized estimating equations were conducted to assess the temporal relationship while controlling for unobserved characteristics of patients.
  
  
  RESULTS
  Better medication adherence was associated with decreased hospitalization and emergency department (ED) visits for diabetes or related conditions. The results also revealed that medication adherence was negatively associated with the expenses of hospitalization and ED visits for diabetes or related conditions, but medication adherence was positively associated with patients' total healthcare expenses. However, the adherence-related differences in total healthcare expenses began to decrease 5 years after the time of diabetes onset.
  
  
  CONCLUSIONS
  Adherence to medication can improve healthcare outcomes but is associated with higher total healthcare expenses, especially during the years immediately following the onset of diabetes. Long-term follow-up is needed for further investigation.
authors.affiliation: Institute of Health Policy and Management, College of Public Health, National Taiwan University, 17, Xu-Zhou Rd, Taipei, Taiwan, 100. E-mail: shcheng@ntu.edu.tw.
authors.forename: Shou-Hsia
authors.initials: SH
authors.lastname: Cheng
authors.forename: Chi-Chen
authors.initials: CC
authors.lastname: Chen
authors.forename: Chin-Hsiao
authors.initials: CH
authors.lastname: Tseng
mesh_terms: D003924:Diabetes Mellitus, Type 2 / Q000188:drug therapy* / Q000191:economics*; D004636:Emergency Service, Hospital / Q000191:economics / Q000706:statistics & numerical data; D005260:Female; D017048:Health Care Costs; D006760:Hospitalization / Q000191:economics / Q000706:statistics & numerical data; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use*; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D013624:Taiwan / Q000453:epidemiology; D019472:Universal Health Insurance; D016903:Drug Monitoring
chemical_list: D007004:Hypoglycemic Agents