Cost-related barriers to medication use among diverse participants with obesity-associated asthma.

IF 2.9 4区医学 Q2 HEALTH CARE SCIENCES & SERVICES

Journal of managed care & specialty pharmacy Pub Date : 2025-09-01 DOI:10.18553/jmcp.2025.31.9.937

Luyu Xie, Joohan Kim, Jaime P Almandoz, Folashade Afolabi, Tanya Martinez Fernandez, Andrew Gelfand, Joshua M Liao, Sarah E Messiah

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引用次数: 0

Abstract

Background: Individuals with obesity-associated asthma (OAA) have worse health outcomes than those with asthma and healthy weight (no OAA). The impact of cost barriers on medication use and how it varies by racial and ethnic groups is unclear.

Objective: To assess the impact of cost barriers on medication use in OAA across racial and ethnic groups.

Methods: This cross-sectional study included adults with asthma who participated in the All of Us program between May 2017 and August 2024. OAA was defined as having both asthma (confirmed by the electronic health record) and obesity (body mass index [BMI]≥30 kg/m²). Main measures included self-reported cost-related barriers to medication use.

Results: A total of 21,108 patients (mean age 58.9 years, 73.6% female, 11.9% Hispanic/Latinx, 67.2% non-Hispanic White, 13.0% non-Hispanic Black, 1.5% non-Hispanic Asian, and 6.3% other) were included, with 51.7% having OAA (mean BMI of 38.6 kg/m²). Individuals with OAA had higher odds of experiencing cost-related barriers (adjusted odds ratio [aOR] range = 1.12-1.31, all P < 0.05) vs those without OAA. Despite greater affordability challenges, non-Hispanic Black (aOR = 0.82, 95% CI = 0.69-0.96, P = 0.013) and Hispanic individuals (aOR = 0.80, 95% CI = 0.65-0.98, P = 0.033) with OAA were less likely to skip medications compared with non-Hispanic White individuals. Both groups were also less likely to request lower-cost alternatives (aOR = 0.72, 95% CI = 0.64-0.82, P < 0.001; aOR = 0.65, 95% CI = 0.55-0.77, P < 0.001, respectively).

Conclusions: Significant disparities exist in cost-related barriers among individuals with OAA from different ethnic backgrounds. This highlights the need for tailored health care interventions that address the specific needs of diverse populations, aiming to reduce health disparities and improve asthma outcomes.

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不同肥胖相关哮喘患者使用药物的成本相关障碍

背景：肥胖相关性哮喘（OAA）患者的健康结果比哮喘和健康体重（无OAA）患者差。成本障碍对药物使用的影响以及它在种族和民族群体中的差异尚不清楚。目的：评估成本障碍对不同种族和民族OAA患者用药的影响。方法：本横断面研究纳入了2017年5月至2024年8月期间参加All of Us项目的成人哮喘患者。OAA定义为同时患有哮喘（经电子健康记录证实）和肥胖（体重指数[BMI]≥30 kg/m2）。主要措施包括自我报告的与费用有关的药物使用障碍。结果：共纳入21108例患者（平均年龄58.9岁，73.6%为女性，11.9%为西班牙裔/拉丁裔，67.2%为非西班牙裔白人，13.0%为非西班牙裔黑人，1.5%为非西班牙裔亚裔，6.3%为其他），其中51.7%为OAA（平均BMI为38.6 kg/m2）。与非西班牙裔白人相比，OAA患者经历费用相关障碍的几率更高（调整比值比[aOR]范围= 1.12-1.31，所有P = 0.013），西班牙裔患者（aOR = 0.80, 95% CI = 0.65-0.98, P = 0.033）， OAA患者不太可能跳过药物治疗。两组患者也不太可能要求低成本的替代方案（aOR = 0.72, 95% CI = 0.64-0.82， P）。结论：不同种族背景的OAA患者在成本相关障碍方面存在显著差异。这突出表明，需要针对不同人群的具体需求制定量身定制的卫生保健干预措施，旨在缩小健康差距并改善哮喘结局。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of managed care & specialty pharmacy Health Professions-Pharmacy

CiteScore

3.50

自引率

4.80%

发文量

131

期刊介绍： JMCP welcomes research studies conducted outside of the United States that are relevant to our readership. Our audience is primarily concerned with designing policies of formulary coverage, health benefit design, and pharmaceutical programs that are based on evidence from large populations of people. Studies of pharmacist interventions conducted outside the United States that have already been extensively studied within the United States and studies of small sample sizes in non-managed care environments outside of the United States (e.g., hospitals or community pharmacies) are generally of low interest to our readership. However, studies of health outcomes and costs assessed in large populations that provide evidence for formulary coverage, health benefit design, and pharmaceutical programs are of high interest to JMCP’s readership.