Does increased adherence to medications change health care financial burdens for adults with diabetes?

J Diabetes. 2015 Nov;7(6):872-80. doi: 10.1111/1753-0407.12292. Epub 2015 May 6.


Background: The aim of the present study was to investigate increased out-of-pocket drug costs and financial burdens of achieving adherence to oral antidiabetic medications and medications for prevalent comorbidities.

Methods: Concurrent adherence to medications, out-of-pocket drug costs, and financial burdens were measured among non-elderly adults with diabetes in the Medical Expenditure Panel Survey. "Financial burden" was defined as spending on health care exceeding 10% of family income. This study simulated the increased out-of-pocket drug costs and financial burdens that would result if non-adherent adults in our sample had obtained sufficient medications to be adherent. For each adult, for all therapeutic classes in which they were non-adherent, we calculated the additional days supplied required to become adherent, as well as out-of-pocket spending on these additional days supplied.

Results: Approximately one-quarter adhered to all required medications. Among non-adherent adults with employer-sponsored insurance and public insurance, the mean annual out-of-pocket drug costs of achieving adherence were US$171 and US$68, respectively, which was generally affordable. However, 35.6% of the uninsured lived in families that spent 10% or more of their income on health care. Mean simulated additional out-of-pocket drug costs of achieving adherence were US$310 for the uninsured. These additional drug costs would increase those spending 10% or more of income to 39.6% of the uninsured.

Conclusions: Efforts to reduce the costs faced by the uninsured and insured will make adherence more affordable and, therefore, more attainable for some adults with diabetes.

Keywords: diabetes mellitus; medication adherence; out-of-pocket spending; 关键词:糖尿病,药物依从性,自费费用.

MeSH terms

  • Administration, Oral
  • Comorbidity
  • Computer Simulation
  • Cost Savings
  • Cost of Illness
  • Cost-Benefit Analysis
  • Diabetes Mellitus / diagnosis
  • Diabetes Mellitus / drug therapy*
  • Diabetes Mellitus / economics*
  • Diabetes Mellitus / epidemiology
  • Drug Costs*
  • Female
  • Health Care Surveys
  • Health Expenditures*
  • Humans
  • Hypoglycemic Agents / administration & dosage*
  • Hypoglycemic Agents / economics*
  • Male
  • Medication Adherence*
  • Middle Aged
  • Models, Economic
  • Prevalence
  • Surveys and Questionnaires
  • Time Factors
  • Treatment Outcome
  • United States / epidemiology


  • Hypoglycemic Agents