| Background. There is a high prevalence of cost-related medication nonadherence among U.S. Medicare seniors. Of the common diseases, pulmonary disease is associated with particularly high rates of medication nonadherence.;Objective. We examined the role of inhaled medications as a risk factor for both cost-related and overall medication nonadherence.;Design. Cross-sectional survey.;Participants. National stratified random sample of community-dwelling Medicare beneficiaries age 65 and older.;Main Outcome Measures. Rates of cost-related nonadherence and overall medication nonadherence in relation to use of inhaled medications for chronic respiratory disease.;Results. In models that did not include out of pocket inhaler costs, respondents with asthma or COPD who were prescribed inhalers were 40% more likely to report cost-related nonadherence and 20% more likely to report overall medical nonadherence than respondents without chronic pulmonary disease. After adjustment for out of pocket inhaler cost, however, this excess risk of non-adherence was not observed. Compared to patients who had no out-of-pocket inhaler costs, patients paying between ;Conclusions. Most, if not all, of the increased risk of non-adherence related to use of inhaled medications is due to high out-of-pocket costs. Physicians should be aware that inhalers can pose a particularly high-risk of cost-related nonadherence for some of their patients. From a health policy perspective, lower copayments for inhaled medications might improve adherence rates and health outcomes for seniors with chronic respiratory disease. |
