Document Detail


Prevalence and cost of medication nonadherence in Parkinson's disease: evidence from administrative claims data.
MedLine Citation:
PMID:  20131374     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
Keith L Davis; Heather M Edin; Jeffery K Allen
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Movement disorders : official journal of the Movement Disorder Society     Volume:  25     ISSN:  1531-8257     ISO Abbreviation:  Mov. Disord.     Publication Date:  2010 Mar 
Date Detail:
Created Date:  2010-03-23     Completed Date:  2010-08-10     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8610688     Medline TA:  Mov Disord     Country:  United States    
Other Details:
Languages:  eng     Pagination:  474-80     Citation Subset:  IM    
Affiliation:
Health Economics, RTI Health Solutions, Research Triangle Park, North Carolina 27709, USA. kldavis@rti.org
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MeSH Terms
Descriptor/Qualifier:
Aged
Antiparkinson Agents / therapeutic use*
Cost-Benefit Analysis
Drug Costs
Drug Prescriptions / economics,  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*,  economics,  epidemiology
Patient Compliance / statistics & numerical data*
Prevalence
Chemical
Reg. No./Substance:
0/Antiparkinson Agents; 0/Levodopa

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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