In the JournalsPerspective

Women more likely to not take diabetes medications due to cost

Soumitra Bhuyan
Soumitra S. Bhuyan

Women with diabetes were 30% more likely than men to not take their medications because of costs, according to findings recently published in the Journal of the American Board of Family Medicine.

“We hypothesized that we would find gender differences in medication nonadherence due to costs among diabetic patients,” Soumitra S. Bhuyan, PhD, MPH an assistant professor in the division of health systems, management, and policy at the School of Public Health at the University of Memphis told Healio Family Medicine.

Bhuyan and colleagues analyzed National Health Interview Survey data of 5,260 men and 6,188 women with diabetes for more than a year. In the entire sample, they found that 29.9% asked for cheaper medications, 14.6% postponed filling prescriptions, 12.2% took less medication than prescribed and 11.8% skipped medication.

In addition, women were more likely to skip medication (OR = 1.3; 95% CI, 1.09-1.55), take less than prescribed medication (OR = 1.26; 95%, CI, 1.06-1.5), ask for cheaper medication (OR = 1.17; 95% CI, 1.04-1.32) and postpone filling prescriptions (OR = 1.29; 95% CI, 1.11-1.5) than men.

“Our study adds new knowledge in that it found that the cost of medication affects females with diabetes more than males with diabetes. Costs are a significant barrier among female patients and the costs may restrict them from adhering to their medication,” Bhuyan said in the interview.

“It does seem possible to take actions to address this problem,” he continued. “Increasing the use of electronic medical records could generate better information for providers. Also, since medication nonadherence can lead to increased health care spending, payers may want to rethink the potential benefits of providing these medications and of programs aimed at enhancing adherence.” - by Janel Miller

Disclosures: The authors report no relevant financial disclosures.

Soumitra Bhuyan
Soumitra S. Bhuyan

Women with diabetes were 30% more likely than men to not take their medications because of costs, according to findings recently published in the Journal of the American Board of Family Medicine.

“We hypothesized that we would find gender differences in medication nonadherence due to costs among diabetic patients,” Soumitra S. Bhuyan, PhD, MPH an assistant professor in the division of health systems, management, and policy at the School of Public Health at the University of Memphis told Healio Family Medicine.

Bhuyan and colleagues analyzed National Health Interview Survey data of 5,260 men and 6,188 women with diabetes for more than a year. In the entire sample, they found that 29.9% asked for cheaper medications, 14.6% postponed filling prescriptions, 12.2% took less medication than prescribed and 11.8% skipped medication.

In addition, women were more likely to skip medication (OR = 1.3; 95% CI, 1.09-1.55), take less than prescribed medication (OR = 1.26; 95%, CI, 1.06-1.5), ask for cheaper medication (OR = 1.17; 95% CI, 1.04-1.32) and postpone filling prescriptions (OR = 1.29; 95% CI, 1.11-1.5) than men.

“Our study adds new knowledge in that it found that the cost of medication affects females with diabetes more than males with diabetes. Costs are a significant barrier among female patients and the costs may restrict them from adhering to their medication,” Bhuyan said in the interview.

“It does seem possible to take actions to address this problem,” he continued. “Increasing the use of electronic medical records could generate better information for providers. Also, since medication nonadherence can lead to increased health care spending, payers may want to rethink the potential benefits of providing these medications and of programs aimed at enhancing adherence.” - by Janel Miller

Disclosures: The authors report no relevant financial disclosures.

    Perspective
    Arch G. Mainous III

    Arch G. Mainous III

    What I found most interesting about Bhuyan et al’s study was how those with public insurance were less likely to skip medication than those on private insurance. I, and Bhuyan and colleagues, seemed to have thought prior to this study that those with private insurance would be setting the gold standard for patient behaviors. It was also interesting how those with usual sources of care would be less likely to take their medications. 

    Looking at the study as whole, the researchers may have gone into it without a hypothesis on those two areas. At the end they say they found a difference between the genders and medication adherence, but they went onto say they don’t know why this is. I don’t doubt their findings, but these findings perhaps could have been bolstered had they looked at comorbidities, provided information on what other medications the participants were on, particularly if they were on medications for diabetes.

    Though we need to know things like how gender differences can impact medication intake, there is just not enough information in this study for primary care physicians to change how they discuss medications with their patients.

    • Arch G. Mainous III, PhD
    • department chair of health services research, management and policy, University of Florida

    Disclosures: Mainous reports no relevant financial disclosures.

    Perspective
    Jen Caudle

    Jen Caudle

    I was surprised by the findings of this study. I do think these results are very interesting and important to consider, but further study needs to be done on gender differences and medication adherence and reasons why people take their medication. In the meantime, this study should serve as a heads-up for primary care physicians that there are other variables that we may not have thought about before on why and how patients don’t take their medication. 

    • Jen Caudle, DO
    • associate professor of family medicine, Rowan University School of Osteopathic Medicine, Stratford, New Jersey

    Disclosures: Healio Family Medicine was unable to determine Caudle's relevant financial disclosures prior to publication.