Prevalence and cost of medication nonadherence in Parkinson's disease: evidence from administrative claims data.
Identifieur interne : 001990 ( PubMed/Corpus ); précédent : 001989; suivant : 001991Prevalence and cost of medication nonadherence in Parkinson's disease: evidence from administrative claims data.
Auteurs : Keith L. Davis ; Heather M. Edin ; Jeffery K. AllenSource :
- Movement disorders : official journal of the Movement Disorder Society [ 1531-8257 ] ; 2010.
English descriptors
- KwdEn :
- Aged, Antiparkinson Agents (therapeutic use), Cost-Benefit Analysis, Drug Costs, Drug Prescriptions (economics), Drug Prescriptions (statistics & numerical data), Female, Health Care Costs (statistics & numerical data), Health Services (utilization), Humans, Insurance Claim Review (statistics & numerical data), Insurance, Health, Reimbursement (statistics & numerical data), Levodopa (therapeutic use), Male, Managed Care Programs (economics), North Carolina (epidemiology), Parkinson Disease (drug therapy), Parkinson Disease (economics), Parkinson Disease (epidemiology), Patient Compliance (statistics & numerical data), Prevalence.
- MESH :
- chemical , therapeutic use : Antiparkinson Agents, Levodopa.
- geographic , epidemiology : North Carolina.
- drug therapy : Parkinson Disease.
- economics : Drug Prescriptions, Managed Care Programs, Parkinson Disease.
- epidemiology : Parkinson Disease.
- statistics & numerical data : Drug Prescriptions, Health Care Costs, Insurance Claim Review, Insurance, Health, Reimbursement, Patient Compliance.
- utilization : Health Services.
- Aged, Cost-Benefit Analysis, Drug Costs, Female, Humans, Male, Prevalence.
Abstract
We estimated the prevalence of medication nonadherence in Parkinson's disease (PD) and the association between treatment nonadherence and healthcare costs. Insurance claims from over 30 US health plans were analyzed. Inclusion criteria were as follows: PD diagnosis, >or=1 PD-related prescription between 1/1/1997 and 12/31/2004, continuous health plan enrollment for >or=6 months before and >or=12 months after first PD prescription. Adherence, all-cause healthcare utilization, and all-cause costs were evaluated over 12 months post-treatment initiation. Adherence was measured using the medication possession ratio (MPR), with MPR < 0.8 defining nonadherence. Among patients identified for inclusion (N = 3,119), 58% were male and mean age was 69 years. Mean MPR was 0.58 and 61% of patients were nonadherent. Unadjusted mean medical costs were significantly higher (P < 0.01) among nonadherers ($15,826) compared with adherers ($9,228), although nonadherers had lower prescription drug costs ($2,684 vs. $3,854; P < 0.05). After controlling for confounders in multivariable analyses, a large positive relationship between nonadherence and both medical and total healthcare costs remained (+$3,451, P < 0.0001 and +$2,383, P = 0.0053, respectively). Medication adherence in PD is suboptimal and nonadherence may be associated with increased healthcare costs despite offsets from reduced drug intake. Efforts to promote medication adherence in PD may lead to cost savings for managed care systems.
DOI: 10.1002/mds.22999
PubMed: 20131374
Links to Exploration step
pubmed:20131374Le document en format XML
<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">Prevalence and cost of medication nonadherence in Parkinson's disease: evidence from administrative claims data.</title><author><name sortKey="Davis, Keith L" sort="Davis, Keith L" uniqKey="Davis K" first="Keith L" last="Davis">Keith L. Davis</name><affiliation><nlm:affiliation>Health Economics, RTI Health Solutions, Research Triangle Park, North Carolina 27709, USA. kldavis@rti.org</nlm:affiliation></affiliation></author><author><name sortKey="Edin, Heather M" sort="Edin, Heather M" uniqKey="Edin H" first="Heather M" last="Edin">Heather M. Edin</name></author><author><name sortKey="Allen, Jeffery K" sort="Allen, Jeffery K" uniqKey="Allen J" first="Jeffery K" last="Allen">Jeffery K. Allen</name></author></titleStmt><publicationStmt><idno type="wicri:source">PubMed</idno><date when="2010">2010</date><idno type="doi">10.1002/mds.22999</idno><idno type="RBID">pubmed:20131374</idno><idno type="pmid">20131374</idno><idno type="wicri:Area/PubMed/Corpus">001990</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en">Prevalence and cost of medication nonadherence in Parkinson's disease: evidence from administrative claims data.</title><author><name sortKey="Davis, Keith L" sort="Davis, Keith L" uniqKey="Davis K" first="Keith L" last="Davis">Keith L. Davis</name><affiliation><nlm:affiliation>Health Economics, RTI Health Solutions, Research Triangle Park, North Carolina 27709, USA. kldavis@rti.org</nlm:affiliation></affiliation></author><author><name sortKey="Edin, Heather M" sort="Edin, Heather M" uniqKey="Edin H" first="Heather M" last="Edin">Heather M. Edin</name></author><author><name sortKey="Allen, Jeffery K" sort="Allen, Jeffery K" uniqKey="Allen J" first="Jeffery K" last="Allen">Jeffery K. Allen</name></author></analytic><series><title level="j">Movement disorders : official journal of the Movement Disorder Society</title><idno type="eISSN">1531-8257</idno><imprint><date when="2010" type="published">2010</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Aged</term><term>Antiparkinson Agents (therapeutic use)</term><term>Cost-Benefit Analysis</term><term>Drug Costs</term><term>Drug Prescriptions (economics)</term><term>Drug Prescriptions (statistics & numerical data)</term><term>Female</term><term>Health Care Costs (statistics & numerical data)</term><term>Health Services (utilization)</term><term>Humans</term><term>Insurance Claim Review (statistics & numerical data)</term><term>Insurance, Health, Reimbursement (statistics & numerical data)</term><term>Levodopa (therapeutic use)</term><term>Male</term><term>Managed Care Programs (economics)</term><term>North Carolina (epidemiology)</term><term>Parkinson Disease (drug therapy)</term><term>Parkinson Disease (economics)</term><term>Parkinson Disease (epidemiology)</term><term>Patient Compliance (statistics & numerical data)</term><term>Prevalence</term></keywords><keywords scheme="MESH" type="chemical" qualifier="therapeutic use" xml:lang="en"><term>Antiparkinson Agents</term><term>Levodopa</term></keywords><keywords scheme="MESH" type="geographic" qualifier="epidemiology" xml:lang="en"><term>North Carolina</term></keywords><keywords scheme="MESH" qualifier="drug therapy" xml:lang="en"><term>Parkinson Disease</term></keywords><keywords scheme="MESH" qualifier="economics" xml:lang="en"><term>Drug Prescriptions</term><term>Managed Care Programs</term><term>Parkinson Disease</term></keywords><keywords scheme="MESH" qualifier="epidemiology" xml:lang="en"><term>Parkinson Disease</term></keywords><keywords scheme="MESH" qualifier="statistics & numerical data" xml:lang="en"><term>Drug Prescriptions</term><term>Health Care Costs</term><term>Insurance Claim Review</term><term>Insurance, Health, Reimbursement</term><term>Patient Compliance</term></keywords><keywords scheme="MESH" qualifier="utilization" xml:lang="en"><term>Health Services</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Aged</term><term>Cost-Benefit Analysis</term><term>Drug Costs</term><term>Female</term><term>Humans</term><term>Male</term><term>Prevalence</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">We estimated the prevalence of medication nonadherence in Parkinson's disease (PD) and the association between treatment nonadherence and healthcare costs. Insurance claims from over 30 US health plans were analyzed. Inclusion criteria were as follows: PD diagnosis, >or=1 PD-related prescription between 1/1/1997 and 12/31/2004, continuous health plan enrollment for >or=6 months before and >or=12 months after first PD prescription. Adherence, all-cause healthcare utilization, and all-cause costs were evaluated over 12 months post-treatment initiation. Adherence was measured using the medication possession ratio (MPR), with MPR < 0.8 defining nonadherence. Among patients identified for inclusion (N = 3,119), 58% were male and mean age was 69 years. Mean MPR was 0.58 and 61% of patients were nonadherent. Unadjusted mean medical costs were significantly higher (P < 0.01) among nonadherers ($15,826) compared with adherers ($9,228), although nonadherers had lower prescription drug costs ($2,684 vs. $3,854; P < 0.05). After controlling for confounders in multivariable analyses, a large positive relationship between nonadherence and both medical and total healthcare costs remained (+$3,451, P < 0.0001 and +$2,383, P = 0.0053, respectively). Medication adherence in PD is suboptimal and nonadherence may be associated with increased healthcare costs despite offsets from reduced drug intake. Efforts to promote medication adherence in PD may lead to cost savings for managed care systems.</div></front></TEI><pubmed><MedlineCitation Owner="NLM" Status="MEDLINE"><PMID Version="1">20131374</PMID><DateCreated><Year>2010</Year><Month>03</Month><Day>23</Day></DateCreated><DateCompleted><Year>2010</Year><Month>08</Month><Day>10</Day></DateCompleted><DateRevised><Year>2013</Year><Month>11</Month><Day>21</Day></DateRevised><Article PubModel="Print"><Journal><ISSN IssnType="Electronic">1531-8257</ISSN><JournalIssue CitedMedium="Internet"><Volume>25</Volume><Issue>4</Issue><PubDate><Year>2010</Year><Month>Mar</Month><Day>15</Day></PubDate></JournalIssue><Title>Movement disorders : official journal of the Movement Disorder Society</Title><ISOAbbreviation>Mov. Disord.</ISOAbbreviation></Journal><ArticleTitle>Prevalence and cost of medication nonadherence in Parkinson's disease: evidence from administrative claims data.</ArticleTitle><Pagination><MedlinePgn>474-80</MedlinePgn></Pagination><ELocationID EIdType="doi" ValidYN="Y">10.1002/mds.22999</ELocationID><Abstract><AbstractText>We estimated the prevalence of medication nonadherence in Parkinson's disease (PD) and the association between treatment nonadherence and healthcare costs. Insurance claims from over 30 US health plans were analyzed. Inclusion criteria were as follows: PD diagnosis, >or=1 PD-related prescription between 1/1/1997 and 12/31/2004, continuous health plan enrollment for >or=6 months before and >or=12 months after first PD prescription. Adherence, all-cause healthcare utilization, and all-cause costs were evaluated over 12 months post-treatment initiation. Adherence was measured using the medication possession ratio (MPR), with MPR < 0.8 defining nonadherence. Among patients identified for inclusion (N = 3,119), 58% were male and mean age was 69 years. Mean MPR was 0.58 and 61% of patients were nonadherent. Unadjusted mean medical costs were significantly higher (P < 0.01) among nonadherers ($15,826) compared with adherers ($9,228), although nonadherers had lower prescription drug costs ($2,684 vs. $3,854; P < 0.05). After controlling for confounders in multivariable analyses, a large positive relationship between nonadherence and both medical and total healthcare costs remained (+$3,451, P < 0.0001 and +$2,383, P = 0.0053, respectively). Medication adherence in PD is suboptimal and nonadherence may be associated with increased healthcare costs despite offsets from reduced drug intake. Efforts to promote medication adherence in PD may lead to cost savings for managed care systems.</AbstractText></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Davis</LastName><ForeName>Keith L</ForeName><Initials>KL</Initials><AffiliationInfo><Affiliation>Health Economics, RTI Health Solutions, Research Triangle Park, North Carolina 27709, USA. kldavis@rti.org</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Edin</LastName><ForeName>Heather M</ForeName><Initials>HM</Initials></Author><Author ValidYN="Y"><LastName>Allen</LastName><ForeName>Jeffery K</ForeName><Initials>JK</Initials></Author></AuthorList><Language>eng</Language><PublicationTypeList><PublicationType UI="D016428">Journal Article</PublicationType><PublicationType UI="D013485">Research Support, Non-U.S. Gov't</PublicationType></PublicationTypeList></Article><MedlineJournalInfo><Country>United States</Country><MedlineTA>Mov Disord</MedlineTA><NlmUniqueID>8610688</NlmUniqueID><ISSNLinking>0885-3185</ISSNLinking></MedlineJournalInfo><ChemicalList><Chemical><RegistryNumber>0</RegistryNumber><NameOfSubstance UI="D000978">Antiparkinson Agents</NameOfSubstance></Chemical><Chemical><RegistryNumber>46627O600J</RegistryNumber><NameOfSubstance UI="D007980">Levodopa</NameOfSubstance></Chemical></ChemicalList><CitationSubset>IM</CitationSubset><MeshHeadingList><MeshHeading><DescriptorName MajorTopicYN="N" UI="D000368">Aged</DescriptorName></MeshHeading><MeshHeading><DescriptorName MajorTopicYN="N" UI="D000978">Antiparkinson Agents</DescriptorName><QualifierName MajorTopicYN="Y" UI="Q000627">therapeutic use</QualifierName></MeshHeading><MeshHeading><DescriptorName MajorTopicYN="N" UI="D003362">Cost-Benefit Analysis</DescriptorName></MeshHeading><MeshHeading><DescriptorName MajorTopicYN="N" UI="D016527">Drug Costs</DescriptorName></MeshHeading><MeshHeading><DescriptorName MajorTopicYN="N" UI="D011307">Drug 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MajorTopicYN="N" UI="D007349">Insurance, Health, Reimbursement</DescriptorName><QualifierName MajorTopicYN="N" UI="Q000706">statistics & numerical data</QualifierName></MeshHeading><MeshHeading><DescriptorName MajorTopicYN="N" UI="D007980">Levodopa</DescriptorName><QualifierName MajorTopicYN="Y" UI="Q000627">therapeutic use</QualifierName></MeshHeading><MeshHeading><DescriptorName MajorTopicYN="N" UI="D008297">Male</DescriptorName></MeshHeading><MeshHeading><DescriptorName MajorTopicYN="N" UI="D008329">Managed Care Programs</DescriptorName><QualifierName MajorTopicYN="N" UI="Q000191">economics</QualifierName></MeshHeading><MeshHeading><DescriptorName MajorTopicYN="N" Type="Geographic" UI="D009657">North Carolina</DescriptorName><QualifierName MajorTopicYN="N" UI="Q000453">epidemiology</QualifierName></MeshHeading><MeshHeading><DescriptorName MajorTopicYN="N" UI="D010300">Parkinson Disease</DescriptorName><QualifierName MajorTopicYN="Y" UI="Q000188">drug therapy</QualifierName><QualifierName MajorTopicYN="N" UI="Q000191">economics</QualifierName><QualifierName MajorTopicYN="N" UI="Q000453">epidemiology</QualifierName></MeshHeading><MeshHeading><DescriptorName MajorTopicYN="N" UI="D010349">Patient Compliance</DescriptorName><QualifierName MajorTopicYN="Y" UI="Q000706">statistics & numerical data</QualifierName></MeshHeading><MeshHeading><DescriptorName MajorTopicYN="N" UI="D015995">Prevalence</DescriptorName></MeshHeading></MeshHeadingList></MedlineCitation><PubmedData><History><PubMedPubDate PubStatus="entrez"><Year>2010</Year><Month>2</Month><Day>5</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="pubmed"><Year>2010</Year><Month>2</Month><Day>5</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="medline"><Year>2010</Year><Month>8</Month><Day>11</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate></History><PublicationStatus>ppublish</PublicationStatus><ArticleIdList><ArticleId 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