SHM Converge Scientific Abstract ePoster Gallery-Have Less, Pay More: Assessing New Medication Cost, Primary Adherence, and Readmission Rates for Discharging Patients Without Prescription Insurance

Have Less, Pay More: Assessing New Medication Cost, Primary Adherence, and Readmission Rates for Discharging Patients Without Prescription Insurance

Back to course

Pdf Summary

This study examined the financial burden of newly prescribed chronic medications for hospitalized patients discharged home without prescription drug insurance. The investigators enrolled 73 eligible adults from an inpatient general medicine service, who received new long-term tablet or capsule medications at discharge and had to pay full out-of-pocket costs.<br /><br />The main finding was that medication costs were substantial. Depending on the pricing source used, the estimated annual cost ranged from about $523 using pharmacy-reported prices to about $3,242 using national retail GoodRx estimates, with wholesale NADAC prices and other estimates falling in between. The authors suggest that the true annual cost for many patients is likely around $2,000–$3,000.<br /><br />Secondary outcomes showed poor medication access and concerning downstream outcomes. Primary medication adherence—defined as filling the prescription within 30 days—was only 46.9% to 49.7%, well below the 72% rate reported in a large outpatient comparison study. The 30-day readmission rate was 27.4%, higher than both the national average (17%) and the institution’s average (16.1%).<br /><br />Overall, the study concludes that uninsured patients or those without prescription coverage face high out-of-pocket costs after hospitalization, which likely reduces adherence and may contribute to higher readmission rates. The authors emphasize that hospitalists should pay close attention to medication affordability, adherence barriers, and readmission risk when caring for this vulnerable population.

Asset Subtitle

Alan Kubey

Meta Tag

Author List Alan Kubey, Andrew Greenlund, Deanne T. Kashiwagi, Jordan Haag

Category Research

Concept Medication Cost

Concept Chronic Outpatient Medication

Concept Out-of-Pocket Cost

Concept Primary Adherence

Concept Uninsured Patient

Distinguished Non-Finalist

Presenter Organization Thomas Jefferson University and Mayo Clinic

Presenting Author Alan Kubey

Track Transitions of Care

Keywords

uninsured patients

prescription drug insurance

out-of-pocket costs

chronic medications

hospital discharge

medication adherence

readmission rate

pharmacy prices

GoodRx estimates

medication affordability

Medication Cost

Chronic Outpatient Medication

Out-of-Pocket Cost

Primary Adherence

Uninsured Patient