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Medicine possession ratio as proxy for adherence to antiepileptic drugs: prevalence, associations, and cost implications.

Jacobs K, Julyan M, Lubbe MS, Burger JR, Cockeran M - Patient Prefer Adherence (2016)

Bottom Line: To determine the adherence status to antiepileptic drugs (AEDs) among epilepsy patients; to observe the association between adherence status and age, sex, active ingredient prescribed, treatment period, and number of comorbidities; and to determine the effect of nonadherence on direct medicine treatment cost of AEDs.A retrospective study analyzing medicine claims data obtained from a South African pharmaceutical benefit management company was performed.Direct medicine treatment cost was calculated by summing the medical scheme contribution and patient co-payment associated with each AED prescription.

View Article: PubMed Central - PubMed

Affiliation: Medicine Usage in South Africa, Faculty of Health Sciences, North-West University (Potchefstroom Campus), Potchefstroom, South Africa.

ABSTRACT

Objective: To determine the adherence status to antiepileptic drugs (AEDs) among epilepsy patients; to observe the association between adherence status and age, sex, active ingredient prescribed, treatment period, and number of comorbidities; and to determine the effect of nonadherence on direct medicine treatment cost of AEDs.

Methods: A retrospective study analyzing medicine claims data obtained from a South African pharmaceutical benefit management company was performed. Patients of all ages (N=19,168), who received more than one prescription for an AED, were observed from 2008 to 2013. The modified medicine possession ratio (MPRm) was used as proxy to determine the adherence status to AED treatment. The MPRm was considered acceptable (adherent) if the calculated value was ≥80%, but ≤110%, whereas an MPRm of <80% (unacceptably low) or >110% (unacceptably high) was considered nonadherent. Direct medicine treatment cost was calculated by summing the medical scheme contribution and patient co-payment associated with each AED prescription.

Results: Only 55% of AEDs prescribed to 19,168 patients during the study period had an acceptable MPRm. MPRm categories depended on the treatment period (P>0.0001; Cramer's V=0.208) but were independent of sex (P<0.182; Cramer's V=0.009). Age group (P<0.0001; Cramer's V=0.067), active ingredient (P<0.0001; Cramer's V=0.071), and number of comor-bidities (P<0.0001; Cramer's V=0.050) were statistically but not practically significantly associated with MPRm categories. AEDs with an unacceptably high MPRm contributed to 3.74% (US$736,376.23) of the total direct cost of all AEDs included in the study, whereas those with an unacceptably low MPRm amounted to US$3,227,894.85 (16.38%).

Conclusion: Nonadherence to antiepileptic treatment is a major problem, encompassing ~20% of cost in our study. Adherence, however, is likely to improve with the treatment period. Further research is needed to determine the factors influencing epileptic patients' prescription refill adherence.

No MeSH data available.


Related in: MedlinePlus

Study population selection.Abbreviations: ICD-10, the Tenth Revision of the International Classification of Diseases; CDL, chronic disease list.
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f1-ppa-10-539: Study population selection.Abbreviations: ICD-10, the Tenth Revision of the International Classification of Diseases; CDL, chronic disease list.

Mentions: Patients were included in the study if they 1) had a recorded diagnosis of epilepsy (ICD-10 code G40) during the study period in conjunction with a paid claim reimbursed through the prescribed minimum benefit (PMB) as part of the chronic disease list (CDL) for antiepileptic medicine; and 2) filled a prescription for single or multiple AEDs more than once during the study period (Figure 1).


Medicine possession ratio as proxy for adherence to antiepileptic drugs: prevalence, associations, and cost implications.

Jacobs K, Julyan M, Lubbe MS, Burger JR, Cockeran M - Patient Prefer Adherence (2016)

Study population selection.Abbreviations: ICD-10, the Tenth Revision of the International Classification of Diseases; CDL, chronic disease list.
© Copyright Policy
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4835143&req=5

f1-ppa-10-539: Study population selection.Abbreviations: ICD-10, the Tenth Revision of the International Classification of Diseases; CDL, chronic disease list.
Mentions: Patients were included in the study if they 1) had a recorded diagnosis of epilepsy (ICD-10 code G40) during the study period in conjunction with a paid claim reimbursed through the prescribed minimum benefit (PMB) as part of the chronic disease list (CDL) for antiepileptic medicine; and 2) filled a prescription for single or multiple AEDs more than once during the study period (Figure 1).

Bottom Line: To determine the adherence status to antiepileptic drugs (AEDs) among epilepsy patients; to observe the association between adherence status and age, sex, active ingredient prescribed, treatment period, and number of comorbidities; and to determine the effect of nonadherence on direct medicine treatment cost of AEDs.A retrospective study analyzing medicine claims data obtained from a South African pharmaceutical benefit management company was performed.Direct medicine treatment cost was calculated by summing the medical scheme contribution and patient co-payment associated with each AED prescription.

View Article: PubMed Central - PubMed

Affiliation: Medicine Usage in South Africa, Faculty of Health Sciences, North-West University (Potchefstroom Campus), Potchefstroom, South Africa.

ABSTRACT

Objective: To determine the adherence status to antiepileptic drugs (AEDs) among epilepsy patients; to observe the association between adherence status and age, sex, active ingredient prescribed, treatment period, and number of comorbidities; and to determine the effect of nonadherence on direct medicine treatment cost of AEDs.

Methods: A retrospective study analyzing medicine claims data obtained from a South African pharmaceutical benefit management company was performed. Patients of all ages (N=19,168), who received more than one prescription for an AED, were observed from 2008 to 2013. The modified medicine possession ratio (MPRm) was used as proxy to determine the adherence status to AED treatment. The MPRm was considered acceptable (adherent) if the calculated value was ≥80%, but ≤110%, whereas an MPRm of <80% (unacceptably low) or >110% (unacceptably high) was considered nonadherent. Direct medicine treatment cost was calculated by summing the medical scheme contribution and patient co-payment associated with each AED prescription.

Results: Only 55% of AEDs prescribed to 19,168 patients during the study period had an acceptable MPRm. MPRm categories depended on the treatment period (P>0.0001; Cramer's V=0.208) but were independent of sex (P<0.182; Cramer's V=0.009). Age group (P<0.0001; Cramer's V=0.067), active ingredient (P<0.0001; Cramer's V=0.071), and number of comor-bidities (P<0.0001; Cramer's V=0.050) were statistically but not practically significantly associated with MPRm categories. AEDs with an unacceptably high MPRm contributed to 3.74% (US$736,376.23) of the total direct cost of all AEDs included in the study, whereas those with an unacceptably low MPRm amounted to US$3,227,894.85 (16.38%).

Conclusion: Nonadherence to antiepileptic treatment is a major problem, encompassing ~20% of cost in our study. Adherence, however, is likely to improve with the treatment period. Further research is needed to determine the factors influencing epileptic patients' prescription refill adherence.

No MeSH data available.


Related in: MedlinePlus