The high cost of pharmaceuticals may prevent some patients who have had a stroke from taking the medications prescribed by their physician, putting them at risk for future strokes or other cardiovascular disease events, according to research presented today at the American Stroke Association’s International Stroke Conference in Los Angeles.
The study’s findings show that the young, the uninsured, and those covered by the Medicare Part D drug benefit often cannot afford some or all of the medications (11 on average) taken by stroke survivors, explained Deborah A. Levine, MD, MPH, the study’s lead author and assistant professor of medicine at the University of Michigan in Ann Arbor, at a press conference. The results are based on data from 2656 stroke survivors aged 45 years or older who were living outside of institutional settings and who had participated in the National Health Interview Survey conducted between 2006 and 2009. The researchers then compared patients’ responses with survey data collected between 1998 and 2002.
The researchers asked survey respondents, “Was there any time in the past year when you needed prescription medicines but did not get them because you could not afford them?” The percentage of patients who did not adhere to their medication regimen because of cost increased from 8.6% during the earlier survey to 11% in the latest survey. The percentage of uninsured stroke survivors with nonadherence increased from 39% to 60%.
Among those patients aged 45 to 54 years, nonadherence related to the cost of medications increased significantly between the 2 periods but was unchanged among older stroke survivors. About 12% of participants in Medicare Part D reported they did not adhere to their drug regimens because of costs compared with 6% of Medicare enrollees without the benefit, Levine noted, but that difference disappeared when the researchers controlled for socioeconomic status and use of private insurance.
The findings suggest that physicians need to screen their patients for cost-related barriers to medications and help them find ways to access these therapies, Levine said.