Rohan Khera|Javier Valero?Elizondo|Sandeep R. Das|Salim S. Virani|Bita A. Kash|James A. de Lemos|Harlan M. Krumholz|Khurram Nasir
Cost-Related Medication Nonadherence in Adults With Atherosclerotic Cardiovascular Disease in the United States, 2013 to 2017
The University of Texas Southwestern Medical Center|Yale New Haven Health System|The University of Texas Southwestern Medical Center|Baylor College of Medicine|Houston Methodist|Texas A&M University|The University of Texas Southwestern Medical Center|Yale New Haven Health System|Yale University|Houston Methodist
medication nonadherence associated worse outcomes patients atherosclerotic cardiovascular disease ascvd group requires longterm therapy secondary prevention important understand extent drug costs potentially actionable factors contribute medication nonadherencein nationally representative survey us adults national health interview survey 20132017 identified individuals 18 years reported history ascvd participants considered experienced costrelated nonadherence crn preceding 12 months reported skipping doses save money taking less medication save money delaying filling prescription save money used survey analysis obtain national estimatesof 14 279 surveyed individuals ascvd weighted 126 22 million 95 ci 2124 experienced crn including 86 15 million missing doses 88 16 million taking lower prescribed doses 105 19 million intentionally delaying medication fill save costs age 65 years female sex low family income lack health insurance high comorbidity burden independently associated crn 1 5 reporting crn subgroups survey respondents crn compared without crn 108fold higher odds requesting lowcost medications 89fold higher odds using alternative nonprescription therapiesone 8 patients ascvd reports nonadherence medications cost removal financial barriers accessing medications particularly among vulnerable patient groups may help improve adherence essential therapy reduce ascvd morbidity mortality