A new study sheds light on factors that make it more likely patients with cancer will not adhere to their treatment because of cost reasons.
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Cost-related non-adherence for cancer survivors is correlated with treatment failure as well as increased health care costs. As costs of cancer diagnosis, treatment, and follow-up care have steadily increased, patients have experienced increased out-of-pocket expenses at an unprecedented rate. Estimates of cost-related non-adherence rates range from 30% to 60% for cancer survivors. Patients have resorted to lifestyle-altering strategies (including spending less on basic necessities, borrowing money, or spending savings) and care-altering strategies to offset financial hardship caused by increasing costs of cancer treatment.
Previous studies have shown gender differences associated with diagnosis, treatment, and mortality among patients with cancer. But gender differences in relation to cost-related non-adherence is a topic yet to be explored. Now a study led by Minjee Lee, Department of Health Services Policy and Management, Arnold School of Public Health, University of South Carolina, has shown that even after controlling for socioeconomic demographics, health status, or insurance coverage, gender differences exist in cost-related non-adherence.
The researchers utilized the National Health Interview Survey from 2006 through 2013 to sample 15,159 cancer survivors (5713 men and 9446 women). Of all the sampled patients, 7.4% male and 12.5% female reported cost-related non-adherence. Prevalence of cost-related non-adherence was found to be significantly high for uninsured patients and significantly low for patients with access to Medicare, but gender differences were noted across all insurance types.
After controlling for relevant covariates including socioeconomic demographics, marital status, region, education level, health care coverage, and comorbidities, researchers found females to be 27% more likely (odds ratio, 1.27; CI, 1.06–1.53) than males to report cost-related non-adherence.
Inability to afford medication was reported by 40.8% of uninsured male cancer survivors and 48.9% of uninsured female cancer survivors. Researchers reported that “the generosity of private insurance plans differs significantly” between male and female cancer survivors, which could help explain the gender disparity for reported cost-related non-adherence.
Researchers concluded that due to increasing drug costs, it is essential to closely monitor cost-related non-adherence rates not only in the female subgroup, but in all high-risk subgroups of cancer survivors.
