Medication Nonadherence Among Medicare Beneficiaries with Comorbid Chronic Conditions: Influence of Pharmacy Dispensing Channel

. 2016 May;22(5):10.18553/jmcp.2016.22.5.550. doi: 10.18553/jmcp.2016.22.5.550

	Home Delivery	Retail
Number	2,437	1,720
	Mean (SD)
Age, years	73.2 (6.0)	73.1 (6.1)^a
OOP costs per 30-day adjusted prescriptions for antidiabetics	10.16 (13.88)	6.32 (9.51)^a
OOP costs per 30-day adjusted prescriptions for antihypertensives	7.87 (8.85)	5.52 (6.20)^a
OOP costs per 30-day adjusted prescriptions for antihyperlipidemics	10.93 (13.31)	6.71 (8.27)^a
Disease burden proxy^b	1.8 (2.2)	3.6 (3.5)^a
Severity of illness proxy for diabetes^c	1.5 (0.7)	1.4 (0.6)^a
Severity of illness proxy for hypertension^c	1.9 (0.9)	2.0 (0.9)^a
	n (%)
Baseline adherent for antidiabetics	2,114 (86.8)	1,450 (84.3)^a
Baseline adherent for antihypertensives	2,185 (89.7)	1,486 (86.4)^a
Baseline adherent for antihyperlipidemics	2,231 (91.6)	1,505 (87.5)^a
Female	1,031 (42.3)	833 (48.4)^a
Urbanicity	2,310 (94.8)	1,618 (94.1)^a
LIS beneficiaries	50 (2.1)	313 (18.2)^a

^a Significantly different from home delivery at P < 0.05.

^b Patient overall disease burden was defined as the number of unique 2-digit GPIs (except diabetes, hypertension, and high blood cholesterol), which indicate distinct drug therapy classes used by the patient beyond the 3 therapy classes.

^c Severity of illness is defined by the number of unique drug groups for which the patient had a prescription claim in 2012 for diabetes and hypertension.

GPI = Generic Product Identifier; LIS = low-income subsidy; OOP = out of pocket; SD = standard deviation.