title: Do cancer survivors change their prescription drug use for financial reasons? Findings from a nationally representative sample in the United States.
abstract: There is limited evidence from nationally representative samples about changes in prescription drug use for financial reasons among cancer survivors in the United States.
  
  
  
  The 2011 to 2014 National Health Interview Survey was used to identify adults who reported ever having been told they had cancer (cancer survivors; n = 8931) and individuals without a cancer history (n = 126,287). Measures of changes in prescription drug use for financial reasons included: 1) skipping medication doses, 2) taking less medicine, 3) delaying filling a prescription, 4) asking a doctor for lower cost medication, 5) buying prescription drugs from another country, and 6) using alternative therapies. Multivariable logistic regression analyses were controlled for demographic characteristics, number of comorbid conditions, interactions between cancer history and number of comorbid conditions, and health insurance coverage. Main analyses were stratified by age (nonelderly, ages 18-64 years; elderly, ages ≥65 years) and time since diagnosis (recently diagnosed, <2 years; previously diagnosed, ≥2 years).
  
  
  
  Among nonelderly individuals, both recently diagnosed (31.6%) and previously diagnosed (27.9%) cancer survivors were more likely to report any change in prescription drug use for financial reasons than those without a cancer history (21.4%), with the excess percentage changes for individual measures ranging from 3.5% to 9.9% among previously diagnosed survivors and from 2.6% to 2.7% among recently diagnosed survivors (P < .01). Elderly cancer survivors and those without a cancer history had comparable rates of changes in prescription drug use for financial reasons.
  
  
  
  Nonelderly cancer survivors are particularly vulnerable to changes in prescription drug use for financial reasons, suggesting that targeted efforts are needed. Cancer 2017;123:1453-1463. © 2016 American Cancer Society.
authors.affiliation: Surveillance and Health Services Research Program, American Cancer Society, Atlanta, Georgia.|University of Maryland School of Pharmacy, Baltimore, Maryland.
authors.forename: Zhiyuan
authors.initials: Z
authors.lastname: Zheng
authors.affiliation: Surveillance and Health Services Research Program, American Cancer Society, Atlanta, Georgia.
authors.forename: Xuesong
authors.initials: X
authors.lastname: Han
authors.affiliation: Division of Cancer Prevention and Control, Centers for Disease Control and Prevention, Atlanta, Georgia.
authors.forename: Gery P
authors.initials: GP
authors.lastname: Guy
authors.affiliation: Department of Health Policy and Management, Yale School of Public Health, New Haven, Connecticut.
authors.forename: Amy J
authors.identifier: 0000-0001-8141-9249
authors.initials: AJ
authors.lastname: Davidoff
authors.affiliation: Division of Cancer Prevention and Control, Centers for Disease Control and Prevention, Atlanta, Georgia.
authors.forename: Chunyu
authors.initials: C
authors.lastname: Li
authors.affiliation: The Center for Health Research, Kaiser Permanente, Portland, Oregon.
authors.forename: Matthew P
authors.initials: MP
authors.lastname: Banegas
authors.affiliation: Division of Cancer Prevention and Control, Centers for Disease Control and Prevention, Atlanta, Georgia.
authors.forename: Donatus U
authors.initials: DU
authors.lastname: Ekwueme
authors.affiliation: Division of Cancer Control and Population Sciences, National Cancer Institute, Rockville, Maryland.
authors.forename: K Robin
authors.initials: KR
authors.lastname: Yabroff
authors.affiliation: Surveillance and Health Services Research Program, American Cancer Society, Atlanta, Georgia.
authors.forename: Ahmedin
authors.initials: A
authors.lastname: Jemal
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000970:Antineoplastic Agents / Q000008:administration & dosage / Q000191:economics; D015897:Comorbidity; D000529:Complementary Therapies / Q000191:economics; D003430:Cross-Sectional Studies; D057915:Drug Substitution; D006801:Humans; D007348:Insurance, Health; D008875:Middle Aged; D009369:Neoplasms / Q000188:drug therapy / Q000453:epidemiology*; D055553:Prescription Drugs / Q000191:economics*; D011795:Surveys and Questionnaires; D017741:Survivors; D014481:United States / Q000453:epidemiology; D055815:Young Adult
chemical_list: D000970:Antineoplastic Agents; D055553:Prescription Drugs
keywords: cancer survivors; comorbid conditions; financial burden; high-deductible plan; prescription drugs