Kaplan Cameron M, Waters Teresa M, Clear Emily R, Graves Elizabeth E, Henderson Stephanie
University of Southern California, Los Angeles, USA.
University of Kentucky, Lexington, USA.
Med Care Res Rev. 2024 Apr;81(2):87-95. doi: 10.1177/10775587231218050. Epub 2024 Jan 4.
Prescription drug cost-sharing is a barrier to medication adherence, particularly for low-income and minority populations. In this systematic review, we examined the impact of prescription drug cost-sharing and policies to reduce cost-sharing on racial/ethnic and income disparities in medication utilization. We screened 2,145 titles and abstracts and identified 19 peer-reviewed papers that examined the interaction between cost-sharing and racial/ethnic and income disparities in medication adherence or utilization. We found weak but inconsistent evidence that lower cost-sharing is associated with reduced disparities in adherence and utilization, but studies consistently found that significant disparities remained even after adjusting for differences in cost-sharing across individuals. Study designs varied in their ability to measure the causal effect of policy or cost-sharing changes on disparities, and a wide range of policies were examined across studies. Further research is needed to identify the types of policies that are best suited to reduce disparities in medication adherence.
处方药费用分担是影响药物依从性的一个障碍，对低收入和少数族裔人群而言尤其如此。在这项系统评价中，我们研究了处方药费用分担以及降低费用分担的政策对药物使用方面种族/族裔和收入差异的影响。我们筛选了2145篇标题和摘要，确定了19篇经过同行评审的论文，这些论文研究了费用分担与药物依从性或使用方面的种族/族裔和收入差异之间的相互作用。我们发现证据薄弱且不一致，表明较低的费用分担与依从性和使用方面差异的减少有关，但研究一致发现，即使在调整了个体间费用分担差异之后，显著差异仍然存在。研究设计在衡量政策或费用分担变化对差异的因果效应的能力方面各不相同，并且各项研究考察了广泛的政策。需要进一步研究以确定最适合减少药物依从性差异的政策类型。
