Association between Difficulty Affording Medications and Outcomes in Chronic Obstructive Pulmonary Disease

Area of Science:

• Pulmonary Medicine
• Health Economics
• Social Determinants of Health

Background:

• Inhaled bronchodilators are crucial for managing chronic obstructive pulmonary disease (COPD).
• Medication costs represent a significant out-of-pocket expense for individuals with COPD.
• The relationship between medication affordability and clinical outcomes in COPD remains understudied.

Purpose of the Study:

• To investigate the association between the difficulty of affording medications and COPD-related morbidity.
• To examine the impact of medication affordability challenges on psychological wellbeing.
• To assess the relationship between medication costs and adherence in COPD patients.

Main Methods:

• The study followed 249 individuals diagnosed with COPD for 12 months.
• Patient-reported outcomes, psychological wellbeing, and medication adherence were assessed every six months.
• Multivariable and fixed effects regression models analyzed the association between medication affordability and outcomes over time.

Main Results:

• While baseline difficulty affording medications showed no association with 12-month outcomes, changes over time were significant.
• Increased difficulty affording medications correlated with worse COPD health status, increased dyspnea, and reduced quality of life.
• Changes in affordability were linked to higher anxiety and depression symptoms and lower medication adherence, but not exacerbations.

Conclusions:

• Changes in the ability to afford COPD medications are associated with increased respiratory morbidity, psychological distress, and decreased medication adherence.
• Medication cost is a significant, potentially modifiable social determinant of health for individuals with COPD.
• Targeting medication affordability may improve health outcomes and adherence in the COPD population.