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. 2017 Apr 15;123(8):1453-1463.
doi: 10.1002/cncr.30560. Epub 2017 Feb 20.

Do Cancer Survivors Change Their Prescription Drug Use for Financial Reasons? Findings From a Nationally Representative Sample in the United States

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Free PMC article

Do Cancer Survivors Change Their Prescription Drug Use for Financial Reasons? Findings From a Nationally Representative Sample in the United States

Zhiyuan Zheng et al. Cancer. .
Free PMC article

Abstract

Background: There is limited evidence from nationally representative samples about changes in prescription drug use for financial reasons among cancer survivors in the United States.

Methods: The 2011 to 2014 National Health Interview Survey was used to identify adults who reported ever having been told they had cancer (cancer survivors; n = 8931) and individuals without a cancer history (n = 126,287). Measures of changes in prescription drug use for financial reasons included: 1) skipping medication doses, 2) taking less medicine, 3) delaying filling a prescription, 4) asking a doctor for lower cost medication, 5) buying prescription drugs from another country, and 6) using alternative therapies. Multivariable logistic regression analyses were controlled for demographic characteristics, number of comorbid conditions, interactions between cancer history and number of comorbid conditions, and health insurance coverage. Main analyses were stratified by age (nonelderly, ages 18-64 years; elderly, ages ≥65 years) and time since diagnosis (recently diagnosed, <2 years; previously diagnosed, ≥2 years).

Results: Among nonelderly individuals, both recently diagnosed (31.6%) and previously diagnosed (27.9%) cancer survivors were more likely to report any change in prescription drug use for financial reasons than those without a cancer history (21.4%), with the excess percentage changes for individual measures ranging from 3.5% to 9.9% among previously diagnosed survivors and from 2.6% to 2.7% among recently diagnosed survivors (P < .01). Elderly cancer survivors and those without a cancer history had comparable rates of changes in prescription drug use for financial reasons.

Conclusions: Nonelderly cancer survivors are particularly vulnerable to changes in prescription drug use for financial reasons, suggesting that targeted efforts are needed. Cancer 2017;123:1453-1463. © 2016 American Cancer Society.

Keywords: cancer survivors; comorbid conditions; financial burden; high-deductible plan; prescription drugs.

Conflict of interest statement

CONFLICT OF INTEREST DISCLOSURES

The authors made no disclosures.

Figures

Figure 1
Figure 1
Individual measures and summary measures of changes in prescription drug use for financial reasons are illustrated among cancer survivors and individuals without a cancer history (National Health Interview Survey, 2011–2014). All analyses were stratified by age (nonelderly vs elderly) and time since diagnosis (recently diagnosed vs previously diagnosed). Multivariable logistic regressions controlled for survey year, age, race/ethnicity, sex, educational attainment, marital status, number of comorbid conditions, health insurance coverage, and geographic region. Blue bars represent individuals without a cancer history; red bars, recently diagnosed cancer survivors; green bars, previously diagnosed cancer survivors.
Figure 2
Figure 2
Patterns of changes in prescription drug use for financial reasons are illustrated among nonelderly cancer survivors who were enrolled in high-deductible plans versus low-deductible plans (multivariable adjusted; National Health Interview Survey, 2011–2014).
Figure 3
Figure 3
Patterns of changes in prescription drug use for financial reasons are illustrated by the number of comorbid conditions among cancer survivors only (multivariable, ordered logistic regression stratified by age [18–64 vs ≥ 65 years]; National Health Interview Survey, 2011–2014). Blue areas represent the percentages of cancer survivors that had no change in prescription drug use; red areas, the percentages that had exactly 1 change in prescription drug use; green areas, the percentages that had at least 2 changes in prescription drug use.

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