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Cost-Cutting Behaviors Linked to Poor Outcomes in PsA

VBCR - December 2014, Volume 3, No 6 - Psoriatic Arthritis
Leslie Wyatt

Boston, MA—The method used to administer medication to patients can also heavily impact their medication adherence, placing a lot of importance on the quality and clinical relevance of adherence measures. At the Academy of Managed Care Pharmacy 2014 Nexus meeting, investigators brought attention to medication nonadherence in patients with psoriatic arthritis (PsA).

Identifying Patients with Cost-Cutting Behaviors
Overall, 306 patients aged ≥18 years with a diagnosis of PsA were recruited for the study. Investigators sought to measure cost-cutting behaviors as they relate to loss of work productivity and health conditions. Roxanne Meyer, PharmD, Janssen Scientific Affairs, LLC, Titusville, NJ, and colleagues, conducted cross-sectional, online questionnaires and examined the cost-cutting behaviors of study participants as they related to any health condition from the prior 6 months.

Cost-cutting behaviors were divided into 3 categories: nonadherent cost-cutting behaviors (ie, filling prescriptions less often or not at all, decreasing medication intake, purchasing fewer tablets, cutting tablets in half), adherent cost-cutting behaviors (use of samples or generic brand medications, using coupons or discount cards, ordering medicines by mail on a multimonth basis), and no cost-cutting behaviors.

The results of patients who displayed nonadherent cost-cutting behaviors were compared with those of patients who either engaged in adherent cost-cutting behaviors only, or had no cost-cutting behaviors. Health conditions and loss of work productivity were measured using the Short Form-36 questions version 2 survey and the Work Productivity and Activity Impairment questionnaire, respectively.

Adherent Patients Have Better Mental, Physical Health
Overall, 64% (n = 197) of patients engaged in ≥1 cost-cutting behaviors, whereas 27% (n = 85) reported participating in ≥1 nonadherent cost-cutting behaviors. Among adherent cost-cutting behaviors, purchasing generic brands, using samples, and bulk buying for months at a time via mail or­-der were reported most frequently. Choosing to not fill an expensive prescription was the most frequently reported tactic for patients engaging in nonadherent cost-cutting behavior.

Patients with no or adherent cost-cutting behaviors displayed better mental and physical health than patients participating in nonadherent cost-cutting behaviors, according to investigators. Results also indicated that patients who engaged in nonadherent cost-cutting behaviors were younger and from households with lower incomes, compared with patients who were adherent.

Absenteeism, presenteeism, activity impairment, and overall work impairment were measured for the 7 days prior to the study. Work productivity habits were notably worse in patients who participated in nonadherent cost-cutting behaviors compared with patients who did not engage in such behaviors.

Although the cross-sectional methodology used in this study is a limitation, these data indicate that a considerable number of patients with PsA use nonadherent cost-cutting methods. “Nonadherent cost- cutting behaviors…are associated with worsening health status, decreased work productivity, and more [emergency department] and hospital visits,” Dr Meyer and colleagues reported.

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Last modified: May 21, 2015
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