title: Does increased adherence to medications change health care financial burdens for adults with diabetes?
abstract: BACKGROUND
  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.
  
  
  METHODS
  Concurrent adherence to medications, out-of-pocket drug costs, and financial burdens were measured among non-elderly adults with diabetes in the Medical Expenditure Panel Survey. "Financial burden" was defined as spending on health care exceeding 10% of family income. This study simulated the increased out-of-pocket drug costs and financial burdens that would result if non-adherent adults in our sample had obtained sufficient medications to be adherent. For each adult, for all therapeutic classes in which they were non-adherent, we calculated the additional days supplied required to become adherent, as well as out-of-pocket spending on these additional days supplied.
  
  
  RESULTS
  Approximately one-quarter adhered to all required medications. Among non-adherent adults with employer-sponsored insurance and public insurance, the mean annual out-of-pocket drug costs of achieving adherence were US$171 and US$68, respectively, which was generally affordable. However, 35.6% of the uninsured lived in families that spent 10% or more of their income on health care. Mean simulated additional out-of-pocket drug costs of achieving adherence were US$310 for the uninsured. These additional drug costs would increase those spending 10% or more of income to 39.6% of the uninsured.
  
  
  CONCLUSIONS
  Efforts to reduce the costs faced by the uninsured and insured will make adherence more affordable and, therefore, more attainable for some adults with diabetes.
authors: Division of Modeling and Simulation, Center for Financing, Access and Cost Trends Agency for Healthcare Research and Quality, Rockville, Maryland, USA.
authors: G Edward
authors: GE
authors: Miller
authors: Division of Modeling and Simulation, Center for Financing, Access and Cost Trends Agency for Healthcare Research and Quality, Rockville, Maryland, USA.
authors: Eric M
authors: EM
authors: Sarpong
authors: Division of Modeling and Simulation, Center for Financing, Access and Cost Trends Agency for Healthcare Research and Quality, Rockville, Maryland, USA.
authors: Steven C
authors: SC
authors: Hill
mesh_terms: D000284:Administration, Oral; D015897:Comorbidity; D003198:Computer Simulation; D017046:Cost Savings; D017281:Cost of Illness; D003362:Cost-Benefit Analysis; D003920:Diabetes Mellitus / Q000175:diagnosis / Q000188:drug therapy* / Q000191:economics* / Q000453:epidemiology; D016527:Drug Costs; D005260:Female; D019538:Health Care Surveys; D005102:Health Expenditures; D006801:Humans; D007004:Hypoglycemic Agents / Q000008:administration & dosage* / Q000191:economics*; D008297:Male; D055118:Medication Adherence; D008875:Middle Aged; D018803:Models, Economic; D015995:Prevalence; D011795:Surveys and Questionnaires; D013997:Time Factors; D016896:Treatment Outcome; D014481:United States / Q000453:epidemiology
chemical_list: D007004:Hypoglycemic Agents
keywords: diabetes mellitus; medication adherence; out-of-pocket spending; 关键词：糖尿病，药物依从性，自费费用