Online Program

Inability to Afford Medications across Asian American Ethnicities: Results from the National Health Interview Study (NHIS)

Tuesday, November 3, 2015

Deborah Juarez, ScD, Daniel K. Inouye College of Pharmacy, University of Hawaii, Honolulu, HI
James Davis, PhD, Biostatistics Core, John A. School of Medicine, University of Hawaii, Honolulu, HI
Merle Kataoka-Yahiro, Dr.P.H., MS, APRN, University of Hawaii; School of Nursing and Dental Hygiene, Honolulu, HI
Nafanua Braginsky, University of Hawaii; School of Nursing and Dental Hygiene, Honolulul, HI
Chen-Wen Wang, University of Hawaii; School of Nursing and Dental Hygiene, Honolulul, HI
Cheryl Albright, PhD, MPH, School of Nursing and Dental Hygiene, University of Hawaii, Honolulu, HI
Objective: To examine differences in adults’ inability to afford medications across Asian ethnicities using data from the National Health Interview Survey.

Methods: The study population includes Asians who responded to the National Health Interview Survey (NHIS) in years 2005 to 2012 (n=12,744). Multivariable logistic regression examined differences in inability to afford medications for Asian ethnicities (Asian Indian, Filipinos, Other Asians) relative to Chinese, adjusted for age, gender, region, work status, and chronic conditions.

Results: In our analytic sample, 19.6% were Asian Indian, 20.0% were Chinese, 24.0% were Filipino, and 36.5% were Other Asian. Overall, 4.5% of Asians reported inability to afford medications in the past 12 months. Unadjusted, people of all other Asian ethnicities were more likely than Chinese to report they could not afford medications. In adjusted analyses, Filipinos [OR=1.83, 95%CI(1.23,2.73)] and Other Asians [OR=1.73, 95%CI(1.20,2.50)] were more likely to report inability to afford medications. Being female [OR=1.37, 95%CI(1.10,1.70)], having hypertension [OR=1.39, 95%CI(1.01,1.90)] or diabetes [OR=1.50, 95%CI(1.00,2.24), and being from the South [OR=1.74, 95%CI(1.20,2.52)] or Midwest [OR=1.73, 95%CI(1.15,2.61)] relative to the Northeast, were also associated with a greater inability to afford medications, while  adults over  65y [OR:0.53, 95%CI(0.34,0.83)] , compared to those younger than 30y, were less likely to report inability  to afford medications.

Conclusion: Large differences in cost-related non-adherence were found between Asian ethnicities, indicating significant health disparities and improvements in prescription coverage could alleviate such disparities. Further study is needed using datasets that will include disaggregation of the NHIS’s “Other Asian” group and prescription drug coverage information.

Learning Areas:

Chronic disease management and prevention

Learning Objectives:
Describe differences in ability to afford medications across different Asian populations in the United States. Discuss how patient characteristics, including age, gender, region, and comorbid conditions affect financial access to medications among Asian Americans.

Keyword(s): Accessibility, Pharmacists

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am a health economist and Associate Professor at the Daniel K. Inouye College of Pharmacy at the University of Hawaii. I have my doctorate in health economics from the Harvard School of Public Health.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.