Study design

Observational cross-sectional study.

Objectives

To describe the most common prescription medications used and the extent of out-of-pocket cost, insurance coverage, and cost-related nonadherence (CRNA) for those medications by people with spinal cord injury (SCI) in Canada.

Setting

Community in Canada.

Methods

It was an observational study wherein data were collected through a cross-sectional online survey from individuals living with an SCI in Canada. We used descriptive statistics to describe the extent of drug cost, insurance coverage and CRNA among study sample, and analytical statistics to find association of CRNA with sociodemographic, injury-related and medication-related characteristics of the sample.

Results

Individuals with an SCI (n = 160) used an average of five medications and spent a median of $49 (interquartile range: $234.75) per month on their medications. More than 90% of participants had some form of drug insurance, though 37% reported CRNA. The most common medications that were forgone due to cost included opioids, antidepressants, and drugs for genitourinary and muscular spasms. Individuals with paraplegia and nontraumatic SCI had higher drug costs, though injury-related characteristics did not influence CRNA. Sex, monthly drug expenditure, and monthly additional healthcare costs were significantly associated with CRNA.

Conclusions

People with SCIs are at risk of experiencing CRNA to their prescription medications despite having insurance coverage. Decision makers for the national pharmacare in Canada should account for their concerns judiciously.

中文翻译：

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加拿大脊髓损伤患者的处方药费用、保险范围和与费用相关的不依从性

学习规划

观察性横断面研究。

目标

描述加拿大脊髓损伤 (SCI) 患者最常用的处方药以及自付费用、保险范围和与成本相关的不依从性 (CRNA) 的程度。

环境

加拿大的社区。

方法

这是一项观察性研究，其中数据是通过加拿大 SCI 患者的横断面在线调查收集的。我们使用描述性统计来描述研究样本中药物成本、保险范围和 CRNA 的程度，并使用分析统计来发现 CRNA 与样本的社会人口学、伤害相关和药物相关特征的关联。

结果

患有 SCI 的人 ( n  = 160) 平均使用五种药物，每月在药物上花费的中位数为 49 美元（四分位距：234.75 美元）。超过 90% 的参与者有某种形式的药物保险，尽管 37% 的参与者报告了 CRNA。由于成本原因而放弃的最常见药物包括阿片类药物、抗抑郁药以及治疗泌尿生殖系统和肌肉痉挛的药物。截瘫和非创伤性 SCI 患者的药物成本较高，但损伤相关特征不影响 CRNA。性别、每月药物支出和每月额外医疗保健费用与 CRNA 显着相关。

结论

尽管有保险，但患有 SCI 的人仍面临处方药出现 CRNA 的风险。加拿大国家医药保健的决策者应明智地考虑他们的担忧。