Cost-Related Medication Nonadherence Among Older Adults: Findings From a Nationally Representative Sample

Green C Chung, Richard A Marottoli, Leo M Cooney, Taeho Greg Rhee

Research output: Contribution to journalArticlepeer-review

30 Scopus citations


OBJECTIVES: To estimate the rate of and risk factors associated with cost-related medication nonadherence among older adults.

DESIGN: Cross-sectional analysis of the 2017 National Health Interview Survey (NHIS).

SETTING: Nationally representative health interview survey in the United States.

PARTICIPANTS: Survey respondents, aged 65 years or older (n = 5701 unweighted) in the 2017 wave of the NHIS.

MEASUREMENTS: Self-reported, cost-related medication nonadherence (due to cost: skip dose, reduce dose, or delay or not fill a prescription) and actions taken due to cost-related medication nonadherence (ask for lower-cost prescription, use alternative therapy, or buy medications from another country) were quantified. We used a series of multivariable logistic regression analyses to identify factors associated with cost-related medication nonadherence. We also reported analyses by chronic disease subgroups.

RESULTS: In 2017, 408 (6.8%) of 5901 older adults, representative of 2.7 million older adults nationally, reported cost-related medication nonadherence. Among those with cost-related medication nonadherence, 44.2% asked a physician for lower-cost medications, 11.5% used alternative therapies, and 5.3% bought prescription drugs outside the United States to save money. Correlates independently associated with a higher likelihood of cost-related medication nonadherence included: younger age, female sex, lower socioeconomic levels (eg, low income and uninsured), mental distress, functional limitations, multimorbidities, and obesity (P < .05 for all). Similar patterns were found in subgroup analyses.

CONCLUSION: Cost-related medication nonadherence among older adults is increasingly common, with several potentially modifiable risk factors identified. Interventions, such as medication therapy management, may be needed to reduce cost-related medication nonadherence in older adults.

Original languageEnglish (US)
Pages (from-to)2463-2473
Number of pages11
JournalJournal of the American Geriatrics Society
Issue number12
Early online dateAug 22 2019
StatePublished - Dec 1 2019

Bibliographical note

Funding Information:
Rhee received funding support from the National Institutes of Health (T32AG019134).

Publisher Copyright:
© 2019 The American Geriatrics Society


  • access to care
  • cost
  • medication adherence
  • older adults
  • population health

PubMed: MeSH publication types

  • Journal Article
  • Research Support, N.I.H., Extramural


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