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Cost of medication adherence and persistence in type 2 diabetes mellitus: a literature review

机译：2型糖尿病患者药物依从性和持续性的成本：文献综述

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Purpose: To explore published evidence on health care costs associated with adherence or persistence to antidiabetes medications in adults with type 2 diabetes mellitus (T2DM). Methods: Primary research studies published between January 2006 and December 2015 on compliance, adherence, or persistence and treatment in patients with T2DM that document a link with health care costs were identified through literature searches in bibliographic databases and 2015 abstract books for relevant DM congresses. Results were assessed for relevance by two reviewers. The review was part of a larger overview evaluating the impact of adherence and persistence on a range of clinical and economic outcomes; only findings from the cost element are reported herein. Results: A total of 4,662 de-duplicated abstracts were identified and 110 studies included in the wider review. Of these, 19 reported an association between adherence (n=13), persistence (n=5), or adherence and persistence (n=1), and health care costs. All studies were retrospective, with sample sizes ranging from 301 to 740,195. Medication possession ratio was the most commonly employed adherence measure (n=11). The majority of adherence studies (n=9) reported that medication adherence was associated with lower total health care costs. Pharmacy costs were often increased in adherent patients but this was offset by beneficial effects on other costs. Findings were more variable in persistence studies; three reported that higher pharmacy costs in persistent patients were not sufficiently offset by savings in other areas to result in a reduction in total health care costs. Conclusions: Few studies have evaluated the relationship between adherence, persistence, and health care costs in T2DM. However, it has been consistently shown that medication nonadherence increases health care costs, suggesting that cost savings from better adherence could be substantial. Available data support the economic case for identification of strategies that facilitate improved medication adherence in patients with T2DM.
机译：目的：探讨有关成人2型糖尿病（T2DM）坚持或坚持使用抗糖尿病药物的医疗保健费用的公开证据。方法：2006年1月至2015年12月期间发表的关于T2DM患者依从性，依从性，持久性和治疗的初步研究研究，通过文献数据库和2015年有关DM大会的摘要书中的文献检索，确定了与卫生保健费用相关的文件。两名审阅者对结果进行了相关性评估。该评价是较大的综述的一部分，该综述评估了坚持和坚持对一系列临床和经济结果的影响;本文仅报告了成本要素的发现。结果：总共鉴定了4,662份去重复的摘要，并且110项研究包括在更广泛的综述中。其中，有19个报告了依从性（n = 13），持久性（n = 5）或依从性和持久性（n = 1）与医疗保健费用之间的关联。所有研究均为回顾性研究，样本量范围为301至740,195。药物拥有率是最常用的依从性衡量标准（n = 11）。大多数依从性研究（n = 9）报告说，依从性与较低的总医疗费用有关。依从性患者的药房费用通常会增加，但这被对其他费用的有利影响所抵消。在持久性研究中，发现的变化更大。三人报告说，在持久性患者中较高的药房费用不足以抵消其他领域的节省，从而无法降低总医疗费用。结论：很少有研究评估T2DM的依从性，持久性和医疗费用之间的关系。但是，始终如一地表明，不坚持药物治疗会增加医疗保健成本，这表明通过更好的依从性可以节省大量成本。现有数据为确定有助于改善T2DM患者药物依从性的策略提供了经济依据。

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