Piette John D, Heisler Michele, Wagner Todd H
Department of Veterans Affairs Center for Practice Management and Outcomes Research and Department of Internal Medicine and Michigan Diabetes Research and Training Center, University of Michigan, Ann Arbor, Michigan 48113-0170, USA.
Diabetes Care. 2004 Feb;27(2):384-91. doi: 10.2337/diacare.27.2.384.
To identify problems faced by older adults with diabetes due to out-of-pocket medication costs.
In this cross-sectional national survey of 875 adults with diabetes treated with hypoglycemic medication, respondents reported whether they had underused prescription medications due to cost pressures or had experienced other financial problems associated with medication costs such as forgoing basic necessities. Respondents also described their interactions with clinicians about medication costs.
A total of 19% of respondents reported cutting back on medication use in the prior year due to cost, 11% reported cutting back on their diabetes medications, and 7% reported cutting back on their diabetes medications at least once per month. Moreover, 28% reported forgoing food or other essentials to pay medication costs, 14% increased their credit card debt, and 10% borrowed money from family or friends to pay for their prescriptions. Medication cost problems were especially common among respondents who were younger, had higher monthly out-of-pocket costs, and had no prescription drug coverage. In general, few respondents, including those reporting medication cost problems, reported that their health care providers had given them information or other assistance to address medication cost pressures.
Out-of-pocket medication costs pose a significant burden to many adults with diabetes and contribute to decreased treatment adherence. Clinicians should actively identify patients with diabetes who are facing medication cost pressures and assist them by modifying their medication regimens, helping them understand the importance of each prescribed medication, providing information on sources of low-cost drugs, and linking patients with coverage programs.
确定老年糖尿病患者因自付药费而面临的问题。
在这项针对875名接受降糖药物治疗的成年糖尿病患者的全国性横断面调查中，受访者报告他们是否因费用压力而未充分使用处方药，或是否经历过与药费相关的其他财务问题，如放弃基本生活必需品。受访者还描述了他们与临床医生就药费问题的交流情况。
共有19%的受访者报告上一年因费用问题减少了用药，11%的受访者报告减少了糖尿病药物的使用，7%的受访者报告每月至少减少一次糖尿病药物的使用。此外，28%的受访者报告为支付药费而放弃食物或其他必需品，14%的受访者增加了信用卡债务，10%的受访者向家人或朋友借钱支付处方药费用。药费问题在年龄较小、每月自付费用较高且没有处方药保险的受访者中尤为常见。总体而言，很少有受访者，包括那些报告药费问题的受访者，表示他们的医疗保健提供者为他们提供了信息或其他帮助来应对药费压力。
自付药费给许多成年糖尿病患者带来了沉重负担，并导致治疗依从性下降。临床医生应积极识别面临药费压力的糖尿病患者，并通过调整药物治疗方案、帮助他们理解每种处方药的重要性、提供低成本药物来源信息以及将患者与保险计划联系起来等方式来帮助他们。
