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首页> 外文期刊>Diabetes therapy >Effect of Medication Copayment on Adherence and Discontinuation in Medicare Beneficiaries with Type 2 Diabetes: A Retrospective Administrative Claims Database Analysis
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Effect of Medication Copayment on Adherence and Discontinuation in Medicare Beneficiaries with Type 2 Diabetes: A Retrospective Administrative Claims Database Analysis

机译：药物共付额对2型糖尿病医疗保险受益人坚持和停药的影响：回顾性行政索赔数据库分析

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IntroductionNonadherence 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?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. ResultsOverall, 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 $41, respectively. Increases in copayment increased nonadherence and discontinuation for branded medications but not for generic AHA medications. In both cohorts, elderly patients (≥?75?years of age) had a lower risk of nonadherence and discontinuation. Black patients had a higher risk of nonadherence or discontinuing medication. Patients having more frequent inpatient, emergency room, and/or physician visits were at higher risk of nonadherence or discontinuing therapy in the branded and generic cohorts ( P ?0.001). ConclusionThe impact of drug copayment on adherence and discontinuation varied considerably between branded and generic AHAs. Medicare patients taking branded AHAs had a higher risk of nonadherence with increasing copayment and were more likely to discontinue medication, whereas this association was not observed in patients taking generic medications. FundingMerck & Co, Inc., Kenilworth, NJ, USA. Plain Language SummaryPlain language summary available for this article.
机译：简介对2型糖尿病（T2D）患者使用抗高血糖药（AHA）缺乏依从性会增加发病率和死亡率，以及与医疗相关的费用。这项研究调查了使用仿制药和品牌AHA的T2D老年患者中药物共付与依从性和停药之间的关联。方法在随访期内每10个月60天。在控制人口统计学，临床和合并症的同时，对药物的依从性和停用情况进行了泊松回归。结果总共有160,250例接受AHA单药治疗的患者被纳入分析。开出了131,594（82％）的普通仿制药和28,656（18％）的品牌AHA，平均共付额分别为$ 6和$ 41。共付额的增加增加了品牌药物的不依从性和停药率，而普通AHA药物则没有。在这两个队列中，老年患者（≥75岁）的不依从和停药的风险较低。黑人患者不依从或停药的风险较高。在品牌和普通人群中，住院，急诊室和/或内科医生就诊频率较高的患者发生不依从或中断治疗的风险较高（P <0.001）。结论在品牌AHA和非专利AHA之间，药物共付对依从性和停药的影响差异很大。服用品牌AHA的Medicare患者随着共付额的增加而出现不依从的风险更高，并且更有可能停用药物，而服用普通药物的患者则未观察到这种关联。 FundingMerck＆Co，Inc.，美国新泽西州凯尼尔沃思。普通语言摘要本文提供了普通语言摘要。

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