By Jonathan Springston, Editor, Relias Media

Exorbitant out-of-pocket costs are keeping some patients from adhering to medication prescribed to treat various neurologic conditions, according to the authors of a recent analysis.

Researchers examined 15 years’ worth of private insurance data, specifically identifying tens of thousands of patients with neuropathy, dementia, and Parkinson’s disease (PD). These patients were prescribed gabapentinoids or serotonin/norepinephrine reuptake inhibitors, cholinesterase inhibitors, and dopamine agonists for neuropathy, dementia, and PD, respectively. Investigators considered the fact that various drugs are available to treat these conditions, but costs can fluctuate wildly. For example, ropinirole, a drug used to treat PD, can cost $12.40. Compare that to $35.90 for pramipexole, also used to treat PD.

Across the board, the authors observed associations between higher out-of-pocket costs and lower rates of medication adherence.

“Out-of-pocket costs have risen to the point where systematic changes are needed,” James C. Stevens, MD, FAAN, president of the American Academy of Neurology, which funded the study, said in a statement. “These changes could include legislative action to place a cap on out-of-pocket costs … Another change could be to provide neurologists with access to information on drugs costs so that when they meet with patients to make treatment decisions, they can help to minimize the financial burden.”

Cost is not the only barrier to medication adherence, as noted in an article in the March issue of Hospital Case Management. “If a patient fears he or she will get robbed leaving the pharmacy, he or she is less likely to buy the medication. The patient may be homeless, or simply cannot afford the medication,” author Jeanie Davis wrote. “He or she may struggle with literacy and reading the prescription information. The patient may be depressed, or may not believe the medication will help. These all are realities for patients, especially those living in inner cities.”

Public health researchers are looking closer at not just barriers to care but social determinants of health, the conditions in which people are born, grow, live, work, and age that shape health. Factors like socioeconomic status, education, neighborhood and physical environment, employment, social support networks, and access to healthcare all are important considerations. In response, healthcare systems across the country are launching initiatives to help patients move past these social factors. Be sure to read the whole article to learn more about these programs and other useful tips to help all patients stick to their prescribed regimens.

For new evidence-based summaries of the latest clinical neurology research, be sure to read Neurology Alert.