Cost-related nonadherence to prescription medicines is a common problem with important implications for population health. Relative to men, women may be more vulnerable to cost-related nonadherence because of higher health needs and lower financial resources. Using data from the Commonwealth Fund International Health Policy Survey, we compared cost-related nonadherence among younger (ages 18-64) and older (ages 65 and older) women and men in eleven high-income countries. Among younger adults, the unadjusted female-male disparity was larger in the US compared with other countries: One in four younger women reported cost-related nonadherence compared with one in seven younger men. This large disparity persisted after adjustment for age, income, and chronic conditions. We also found smaller but significant female-male differences among younger women in Australia and Canada. We did not find significant female-male differences among older adults in adjusted analyses in any country. Higher rates of cost-related nonadherence among younger women, and US women in particular, may produce important sex-related disparities in health outcomes that should be further explored.
Keywords: Access to care; Chronic disease; Comparative research; Deductibles; Disparities; Gender; Global health; Government programs and policies; Health policy; International comparison; Pharmaceuticals; Prescription drug costs; Prescription drugs; Sex.