Exhibit 4.

Changes in CRN (A) and spending less on basic needs (B) among overall and sub-groups of community-dwelling Medicare beneficiaries (See Supplemental Appendix Exhibit 1 for details).

(A) Cost-related medication nonadherence
		Adjusted OR a
		Period 1	Period 2	Overall Period
Group	No. b	2009 vs. 2007	2011 vs. 2009	2011 vs. 2007
Elderly	69,697	0.90	1.05	0.95
No. of morbidities
0–3	49,650	0.86	0.97	0.83*
≥4	20,047	0.98	1.20*	1.18*
Income, US$
<25,000	34,776	0.94	0.99	0.94
≥25,000	34,889	0.84	1.12	0.95
(B) Spending less on basic needs
Elderly	69,656	0.71**	1.34**	0.96
No. of morbidities
0–3	49,629	0.65**	1.18	0.77*
≥4	20,027	0.81*	1.54**	1.25*
Income, US$
<25,000	34,748	0.78**	1.25*	0.98
≥25,000	34,876	0.57**	1.60**	0.90

Source: Authors’ analysis.

Notes:

^aAdjusted for younger age, female sex, non-white race, income <$25,000, poor health, survey participation, and having 4 or more morbidities.

^bNumbers of person-years in subgroups do not necessarily add up to overall number of observations. Numbers vary with response rates and availability of data on subgroups.

^*P<0.05

^**P<0.001