One in Eight ASCVD Patients Report Medication Nonadherence Due to Costs

A new analysis published in Circulation reveals that many patients with atherosclerotic cardiovascular disease (ASCVD) reported nonadherence due to costs.

“Medication nonadherence is associated with worse outcomes in patients with ASCVD, a group who requires long-term therapy for secondary prevention,” the researchers explained in their study. “It is important to understand to what extent drug costs, which are potentially actionable factors, contribute to medication nonadherence.”

The study cohort consisted of a nationally representative survey of US adults who participated in the National Health Interview Survey between 2013 and 2017 (n=14,279). Participants were aged 18 years or older and had a reported history of ASCVD. The researchers determined a participant to have experienced cost-related nonadherence (CRN) if the reported skipping medication doses to save money within the previous 12 months, taking less medication to save money, or delaying filling prescriptions to save money. The authors then employed a survey analysis to obtain national estimates.

According to the analysis results, a weighted 12.6% (or 2.2 million; 95% CI, 2.1 to 2.4) of the surveyed participants experienced CRN, including 8.6% missing doses (1.5 million), 8.8% taking lower-than-prescribed doses (1.6 million), and 10.5% intentionally delaying filling prescriptions to save money (1.9 million). A number of factors were associated with CRN, including age over 65 years, female sex, low family income, lack of health insurance, and high comorbidity burden. The authors reported that respondents reporting CRN had a 10.8-fold higher odds of requesting low-cost medications and 8.9-fold higher odds of using alternative, nonprescription therapies compared to those who had not reported CRN.

“One in eight patients with ASCVD reports nonadherence to medications because of cost, the researchers wrote. “The removal of financial barriers to accessing medications, particularly among vulnerable patient groups, may help improve adherence to essential therapy to reduce ASCVD morbidity and mortality.”