Economic hardship still prevents many asthma patients from taking their medication.

Despite a decline in the number of asthma patients who say cost prevents them from taking their medication as prescribed over the past decade, financial hardship remains a deterrent for one in six people with asthma. That's what a study published online in the Journal of Respiratory Medicine suggests. rib cage.

Nonadherence to drug treatment nearly doubled the risk of an asthma attack and increased the risk of emergency room visits by more than 60%, the study showed.

The findings support the importance of health policy in promoting equitable access to drug treatment, the linked editorial concludes.

In 2021, the Centers for Disease Control and Prevention estimated that approximately 20 million adults (8%) in the United States have asthma. Although the condition can be well controlled with medication, researchers note that non-adherence to treatment is high.

To find out what factors cause this condition among people with asthma, researchers surveyed a nationally representative annual National Health Interview Survey (approximately 8% of the U.S. population, or 19.38 million people). We used responses from 30,793 adults with asthma. NHIS) from 2011 to 2022.

Survey respondents were asked about the following in the past 12 months: Have you ever skipped a medication? or reduced the dose. Or you delayed refilling your prescription to save money. Answering “yes” to any of these questions is defined as not following a prescribed treatment plan because of cost.

Respondents were also asked if they had had an episode of asthma/asthma attack in the past 12 months. or had to visit an urgent care or urgent care center for asthma.

Overall, 18% of survey respondents with asthma said they could not afford to take their prescribed medications, just shy of the 3 million people in the U.S. population with asthma.

To save money, 12% of respondents (equivalent to 1.95 million people) said they cut back on medication. 12.5% ​​(equivalent to 2.06 million people) responded that their dose had been reduced. And 15% (equivalent to 2.54 million) said they had delayed repeat prescriptions.

The proportion citing cost as a reason for not adhering to treatment plans decreased significantly over 12 years, from 23% in 2011 to 13% in 2022. However, one in six adults with asthma still cites financial hardship as the reason for their asthma. As a reason for not taking prescribed medication in 2022.

People ages 18 to 60, women, and black people were more likely to report not taking their medications as prescribed because of cost. Other influential factors include living in a southern state, lower educational attainment, lack of health insurance, lower household income, coexisting conditions, and living alone.

People who cited financial hardship as a factor were almost twice as likely to have an asthma attack and more than 60% more likely to seek emergency care than those for whom cost was not a factor.

Because this is an observational study, no clear conclusions can be drawn about causality. The researchers also acknowledged that their study relied on subjective assessments rather than diagnostic tests or medical records, and could not assess the potential impact of asthma severity on medication adherence. There is.

They found that the decline in people citing cost as a reason for not taking their medications as prescribed was due to the 2010 Patient Protection and Affordable Care Act, which was designed to improve access to health insurance and services. It has been suggested that this may be due to the introduction of legislation. Medicaid expanded in 2014.

“With reduced barriers to accessing health care, including medications, patients may be more willing than previously to receive prescriptions for medications to control their asthma,” the researchers suggest. .

In a linked editorial, Emily Graul and Dr. Krister Jansson of Emory University School of Medicine in Atlanta and Uppsala University School of Medicine in Sweden write that asthma medications account for about half of total health care spending. He points out. situation.

“Efforts to reduce cost-related noncompliance will therefore not only reduce the financial burden on the U.S. health care system, but also support people's ability to improve symptoms of their disease.” they suggested, adding that continued policy and legal efforts are needed. This happens.

“The Medicare Drug Price Bargaining Program associated with the Inflation Control Act has lowered drug costs for several chronic conditions, but so far, despite high total annual expenditures, respiratory It does not include drugs for diseases.

“The findings of this study raise the question: Should certain asthma medications be part of the next drug negotiation?”