Lower Out-of-Pocket Costs, Treatment Satisfaction Linked to Improved Medication Adherence

Recent research presented at the 2016 NASP Annual Meeting found that when out-of-pocket costs are lower and treatment satisfaction is high, patients with multiple sclerosis (MS) are more likely to adhere to disease-modifying drugs.

Lori Mayer, DNP, MSN, director of medical research services at Central Texas Neurology Consultants and the MS Clinic of Central Texas, and colleagues sought “To evaluate the impact of patient out‐of‐pocket costs and satisfaction with therapy on adherence to disease‐modifying drugs in patients with MS.”

The researchers studied 1112 patients with MS who were receiving treatment with self‐injectable or oral disease‐modifying drugs. Patient data were gathered using the US National Health and Wellness Survey or Lightspeed Research panel. Study participants completed an internet-based survey that included questions on demographics, disease severity, symptoms, treatments, and comorbidities. Self-reported out-of-pocket costs for physician visits, medications, and other disease-related spending were calculated as monthly estimates. The researchers used the 4‐item Morisky Medication Adherence Scale to measure disease‐modifying drug adherence, and the Treatment Satisfaction Questionnaire for Medication to measure patient satisfaction.

Dr Mayer and colleagues found that of the 805 study participants included in the final analysis, more than half (n = 429) reported high adherence, while 376 participants reported low adherence. They found that questionnaire results measuring satisfaction were significantly higher among those reporting high adherence (P < .05). 

Initially, the researchers found that there were no statistically significant differences in out-of-pocket costs  between both high- and low-adhering patients.  However, after they further classified low-adhering study participants as either moderate or low, comparing high-adherence to low-adherence revealed that costs were significantly higher among the low group. Out-of-pocket physician visit costs in the low group were $42.60, compared to $24.07 in the high-adherence group (P < .05). 

Furthermore, among the newly classified groups, low adherers still had lower satisfaction scores compared to both moderate and high adherers (P < .05). 

“In this real‐world population, lower out-of-pocket costs and greater treatment satisfaction were associated with higher levels of treatment adherence,” Dr Mayer and colleagues concluded.  — David Costill