Wong Edwin S, Maciejewski Matthew L, Liu Chuan-Fen
J Health Care Poor Underserved. 2013 Aug;24(3):1317-30. doi: 10.1353/hpu.2013.0152.
Previous studies have shown prescription copayment increases are associated with decreases in adherence to diabetes and hypertension medications, but have not investigated whether these associations differ by race. Veterans Affairs (VA) administrative data were used to analyze medication adherence before and after an increase in prescription copayments from $2 to $7 for a 30-day supply in February 2002. Applying a difference-in-difference approach, we compared adherence changes among White and Black veterans who were exempt from or required to pay medication copayments. The likelihood patients were adherent to diabetes or hypertension medications decreased after the copayment increase for both White and Black veterans. However, differences in medication adherence reductions between White and Black veterans were small and statistically insignificant. Despite barriers faced by minority patients related to lower perceived value of medications, the impact of a copayment increase on adherence was similar across the two largest racial groups in the VA.
先前的研究表明，处方自付费用的增加与糖尿病和高血压药物的依从性降低有关，但尚未研究这些关联是否因种族而异。退伍军人事务部（VA）的行政数据被用于分析2002年2月处方自付费用从每30天供应量2美元提高到7美元前后的药物依从性。应用差异中的差异方法，我们比较了豁免或需要支付药物自付费用的白人和黑人退伍军人之间的依从性变化。自付费用增加后，白人和黑人退伍军人坚持服用糖尿病或高血压药物的可能性均降低。然而，白人和黑人退伍军人在药物依从性降低方面的差异很小且无统计学意义。尽管少数族裔患者面临与药物感知价值较低相关的障碍，但自付费用增加对依从性的影响在VA的两个最大种族群体中是相似的。
