To explain the association of out‐of‐pocket () cost, community‐level factors, and individual characteristics on statin therapy nonadherence.
BlueCross BlueShield of Texas claims data for the period of 2008–2011.
A retrospective cohort of 49,176 insured patients, aged 18–64 years, with at least one statin refill during 2008–2011 was analyzed. Using a weighted proportion of days covered ratio, differences between adherent and nonadherent groups are assessed using chi‐squared tests, ‐tests, and a clustered generalized linear model with logit link function.
Statin therapy adherence, measured at 48 percent, is associated with neighborhood‐level socioeconomic factors, including race/ethnicity, educational attainment, and poverty level. Individual characteristics influencing adherence include medication cost, gender, age, comorbid conditions, and total health care utilization.
This study signifies the importance of costs as a determinant of adherence to medications, but more interestingly, the results suggest that other socioeconomic factors, as measured by neighborhood‐level variables, have a greater association on the likelihood of adherence. The results may be of interest to policy makers, benefit designers, self‐insured employers, and provider organizations.