The Association Between Type of Insurance Plan, Out-of-Pocket Cost, and Adherence to Antihypertensive Medications in Medicare Supplement Insurance Enrollees.
Am J Hypertens
; 37(8): 631-639, 2024 07 15.
Article
em En
| MEDLINE
| ID: mdl-38727326
ABSTRACT
BACKGROUND:
Medicare supplement insurance, or Medigap, covers 21% of Medicare beneficiaries. Despite offsetting some out-of-pocket (OOP) expenses, remaining OOP costs may pose a barrier to medication adherence. This study aims to evaluate how OOP costs and insurance plan types influence medication adherence among beneficiaries covered by Medicare supplement plans.METHODS:
We conducted a retrospective analysis of the Merative MarketScan Medicare Supplement Database (2017-2019) in Medigap enrollees (≥65 years) with hypertension. The proportion of days covered (PDC) was a continuous measure of medication adherence and was also dichotomized (PDC ≥0.8) to quantify adequate adherence. Beta-binomial and logistic regression models were used to estimate associations between these outcomes and insurance plan type and log-transformed OOP costs, adjusting for patient characteristics.RESULTS:
Among 27,407 patients with hypertension, the average PDC was 0.68â ±â 0.31; 47.5% achieved adequate adherence. A mean $1 higher in 30-day OOP costs were associated with a 0.06 (95% confidence intervals [CIs] -0.09 to -0.03) lower probability of adequate adherence, or a 5% (95% CI 4%-7%) decrease in PDC. Compared with comprehensive plan enrollees, the odds of adequate adherence were lower among those with point-of-service plans (odds ratio [OR] 0.69, 95% CI 0.62-0.77), but higher among those with preferred provider organization (PPO) plans (OR 1.08, 95% CI 1.01-1.15). Moreover, the association between OOP costs and PDC was significantly greater for PPO enrollees.CONCLUSIONS:
While Medicare supplement insurance alleviates some OOP costs, different insurance plans and remaining OOP costs influence medication adherence. Reducing patient cost-sharing may improve medication adherence.Palavras-chave
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Gastos em Saúde
/
Adesão à Medicação
/
Hipertensão
/
Anti-Hipertensivos
Limite:
Aged
/
Aged80
/
Female
/
Humans
/
Male
País como assunto:
America do norte
Idioma:
En
Ano de publicação:
2024
Tipo de documento:
Article