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dc.contributor.authorPawaskar, M.D.
dc.contributor.authorXu, L.
dc.contributor.authorTang, Y.
dc.date.accessioned2019-05-17T13:21:12Z
dc.date.available2019-05-17T13:21:12Z
dc.date.issued2018
dc.identifier.urihttps://www.scopus.com/inward/record.uri?eid=2-s2.0-85054152396&doi=10.1007%2fs13300-018-0489-y&partnerID=40&md5=11ecf47e80f352184293cbe4bcd5474e
dc.identifier.urihttp://hdl.handle.net/10713/9139
dc.description.abstractIntroduction: 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. Methods: 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. Results: 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 nonadherence and discontinuation for branded medications but not for generic AHA medications. In both cohorts, elderly patients (≥ 75years of age) had a lower risk of nonadherence and discontinuation. Black patients had a higher risk of nonadherence or discontinuing medication. Patients having more frequent inpatient, emergency room, and/or physician visits were at higher risk of nonadherence or discontinuing therapy in the branded and generic cohorts (P < 0.001). Conclusion: The impact of drug copayment on adherence and discontinuation varied considerably between branded and generic AHAs. Medicare patients taking branded AHAs had a higher risk of nonadherence with increasing copayment and were more likely to discontinue medication, whereas this association was not observed in patients taking generic medications. Funding: Merck & Co, Inc., Kenilworth, NJ, USA. Plain Language Summary: Plain language summary available for this article. Copyright 2018, The Author(s).en_US
dc.description.sponsorshipEditorial Assistance. Editorial support for development of this manuscript was provided by Alan J. Klopp, PhD, and Lisa Callan, PhD, at C4 MedSolutions, LLC (Yardley, PA), a CHC Group company, and was funded by Merck & Co., Inc., Kenilworth, NJ, USA.en_US
dc.description.urihttps://dx.doi.org/10.1007/s13300-018-0489-yen_US
dc.language.isoen_USen_US
dc.publisherSpringer Healthcareen_US
dc.relation.ispartofDiabetes Therapy
dc.subjectAdherenceen_US
dc.subjectCopaymenten_US
dc.subjectMedicareen_US
dc.subjectType 2 diabetesen_US
dc.titleEffect of Medication Copayment on Adherence and Discontinuation in Medicare Beneficiaries with Type 2 Diabetes: A Retrospective Administrative Claims Database Analysisen_US
dc.typeArticleen_US
dc.identifier.doi10.1007/s13300-018-0489-y


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