From the Journals

Cost, coverage concerns cited as barriers to acne medication adherence



Patients with acne who did not follow through with treatment cited high prices and insurance barriers as their main reasons for medication nonadherence, in a study published in JAMA Dermatology.

In the study, more than half of the 26 participants interviewed reported that they intended to fill the acne prescriptions but were not able to do so because of cost- or insurance-related concerns, reported Kira L. Ryskina, MD, of the Leonard Davis Institute of Health Economics at the University of Pennsylvania, Philadelphia, and her coauthors.

Pills and capsules atop a spread of $100 bills Kenishirotie/Thinkstock
In their study, they first identified 385 potential participants using electronic medical records from four dermatology practices affiliated with the University of Pennsylvania Health System. Participants had been prescribed acne medications by a dermatologist between August 1 and November 3, 2016, but did not initiate treatment. Nonadherence was self-reported and included not submitting prescriptions to the pharmacy, not picking up medications, and picking up but not using medications, the authors said.

Of the initial 385 patients, 26 agreed to participate and met inclusion criteria. Most (58%) were aged 26-40 years, 19% were over aged 40, and 23% were younger than aged 26; 73% were female. Almost 40% had Medicaid coverage, 54% had commercial insurance, and the rest had “other.” Structured interviews were conducted via telephone between November 30, 2016, and January 31, 2017. Based on recorded interviews, five major themes were identified by investigator consensus: medication costs, poor understanding of prior authorization, physician-patient communication about costs, solutions and back-up plans offered by physicians, and reservations about treatment.


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