<b>Objective:</b> Health-related
expenditures due to diabetes are rising in the US. Medication nonadherence is
associated with worse health outcomes among adults with diabetes. <a>We sought to examine the extent of reported cost-related
medication nonadherence (CRN) in individuals with diabetes in the US</a>.
<p><b>Research Design and Methods: </b>We
studied adults ≥18 with self-reported diabetes from the National Health
Interview Survey (NHIS; 2013-18), a US nationally representative survey. Adults
reporting skipping doses, taking less medication, or delaying filling a
prescription to save money in the past year were considered to have experienced
CRN. The weighted prevalence of CRN was estimated overall and by age subgroups
(<65 and ≥65 years). Logistic regression was used to identify
sociodemographic characteristics independently associated with CRN. </p>
<p><b>Results: </b>Of the 20,326 NHIS
participants with diabetes, 17.6% (weighted: 2.3
million) of those aged <65 reported CRN, compared with 6.9% (weighted: 0.7
million) among those aged ≥65. Financial hardship from medical bills, lack of
insurance, low-income, high comorbidity burden and female sex were independently
associated with CRN across age groups. Lack
of insurance, duration of diabetes, current smoking, hypertension, and
hypercholesterolemia were associated with higher odds of reporting CRN among
the non-elderly, but not among the elderly. Among elderly, insulin use
significantly increased the odds of reporting CRN (OR 1.51, 95% CI 1.18, 1.92).</p>
<p><b>Conclusions: </b>In the US, 1 in 6 non-elderly and 1 in 14 elderly adults with diabetes
reported CRN. Removing financial barriers to accessing medications may
improve medication adherence among these patients, with the potential to improve
their outcomes.</p>