Coping with Prescription Medication Costs: a Cross-sectional Look at Strategies Used and Associations with the Physical and Psychosocial Health of Individuals with Arthritis

Abstract

Background Prescription medication costs increase financial burden, often leading individuals to engage in intentional nonadherence. Little is known about what specific medication cost-coping strategies individuals with arthritis employ. Purpose The purposes of this study are (1) to identify characteristics of individuals with arthritis who self-report prescription medication cost-coping strategies and (2) to examine the association between medication cost-coping strategies and health status. Methods Seven hundred twenty-nine people self-reporting arthritis and prescription medication use completed a telephone survey. Adjusted regression models examined medication cost-coping strategies and five health status outcomes. Results Participants reported engaging in cost-coping strategies due to medication costs. Those borrowing money had worse psychosocial health and greater disability; those with increasing credit card debt reported worse physical functioning, self-rated health, and greater helplessness. Medication underuse was associated with worse psychosocial health, greater disability, and depressive symptoms. Conclusion Individuals with arthritis use multiple strategies to cope with medication costs, and these strategies are associated with adverse physical and psychosocial health status.

Health effects of indebtedness: a systematic review

“…A study by Lenton and Mosley [ 11 ], for instance, comprised both objective and quantitative measures of assets, income and expenditures as well as subjective self-assessments of measures pertaining to wellbeing and responses to questions about feelings and attitudes. Collateralized debt was dealt with in five studies [ 7 , 27 , 12 - 14 ] and non-collateralized debt in six studies [ 28 , 6 , 30 , 22 , 18 ]. However, most of the studies covered both collateralized and non-collateralized debt.…”

“…The studies covered debts from different sources. Medical debt was discussed in one study [ 29 ], mortgage in five studies [ 7 , 27 , 12 - 14 ] and borrowing money from a friend or relative or increasing credit card debt in one study [ 28 ]. Credit card debt was specifically focused on in two studies [ 30 , 22 ]; in one of the studies, Drentea and Lavrakas [ 30 ] also observed the financial strain resulting from any debt.…”

“…Individuals use various strategies to cope with the financial burden caused by the high cost of prescription medication. Martin et al [ 28 ] found that those using the cost-coping strategy of borrowing money had worse psychosocial health and greater disability. Those with mounting credit card debt reported worse physical functioning and self-rated health and a greater sense of helplessness.…”

“…These emotions, referred to as financial strain (or worry or concern), may weaken mental health and lead to coping behaviour that is detrimental to health. However, a lack of financial resources may also result in medication underuse [ 28 ].…”

The consequences of patient charges for prescription drugs in Canada: a cross-sectional survey

“…6 High rates of trade-offs have also been shown among patients with chronic obstructive pulmonary disease in Australia and those with arthritis and diabetes in the US. [23][24][25] Prescribers should also be aware that cost-related nonadherence was not limited to expensive medications. This is consistent with our team's qualitative findings suggesting that patients' very individual decisions about taking particular prescriptions are driven primarily by their own assessment of the importance of the medication and the flexibility of their budget.…”