June 21, 2019
More than half of adults with asthma and a third of parents of children with asthma report high rates of underuse of asthma medications due to cost concerns. Study results were published online in The Journal of Allergy and Clinical Immunology: In Practice.
“In asthma, underuse of cost-effective preventive treatments increases morbidity and mortality,” researchers wrote. “The cost of medicines contributes to underuse (‘nonadherence’), but the extent to which people with asthma skip or reduce doses or let prescriptions go unfilled when faced with cost pressures is unknown.”
Researchers conducted an online survey of adults with asthma and parents of children, between the ages of 5 and 17, with asthma. Survey respondents were based in Australia, which researchers noted, is a high-income country.
Among 792 adults with asthma, 52.9% reported cost-related underuse. Among 609 parents of children with asthma, 34.3% reported cost-related underuse. Decreasing or skipping doses to make asthma medications last longer were the most common types of underuse.
Odds of cost-related underuse were higher in younger adults, males, and respondents with concerns about medications, who were less comfortable talking to prescribers about costs or changing medications, who felt less engaged with prescribers about medication decisions, and with poorer asthma control. Neither income nor government assistance with prescription costs was associated with cost-related underuse, according to the study.
“Adults and parents of children with asthma indicate high rates of cost-related underuse of asthma medicines, even in the context of national medicines subsidies,” researchers wrote. “Urgent targeting of interventions to promote discussion of medicines and costs between doctor and patients, particularly young adult males, is needed.”
Laba TL, Jan S, Zwar NA, et al. Cost-related underuse of medicines for asthma-opportunities for improving adherence. The Journal of Allergy and Clinical Immunology: In Practice. 2019 March 27;[Epub ahead of print].