NEW YORK (Reuters Health) - Black and Hispanic Americans are less likely than whites to be able to afford glaucoma medications, a new study shows.
An analysis of data from nearly 4,000 patients with glaucoma revealed that compared to whites with the eye disease, Black and Hispanic patients had roughly 80% higher odds of saying they couldn't afford their medications, researchers report in JAMA Ophthalmology.
"There is a lot of interest in understanding how we can encourage people to take their medications as prescribed," said Dr. Sally Baxter of the University of California, San Diego, who worked on the study. "However, patients cannot adhere to medication regimens if they cannot afford the medications to begin with. This remains a key challenge, particularly in racial/ethnic minority groups who already disproportionately bear the burden of this blinding disease."
"Socioeconomic factors such as income, employment status, and type of insurance may contribute," she told Reuters Health by email. "However, we found that the difficulty with affording medications persisted even when we used statistical techniques to account for these socioeconomic factors. One interesting finding was that we found that on average, individuals from racial/ethnic minority groups were less likely to ask their physicians for more affordable medications. In addition, physicians often do not know the costs of the medications they prescribe and do not always discuss the costs of treatment with their patients. Therefore, these groups may end up being prescribed higher-cost medications that they have trouble affording."
To take a closer look at whether race/ethnicity impacted medication adherence among patients with glaucoma, the researchers turned to information from the National Institutes of Health 'All of Us' Research Program, a nationwide database with an emphasis on diversity.
They identified nearly 15,400 patients with a diagnosis of glaucoma in the database, 5,423 of whom answered the medication-adherence questions in the Health Care Access and Utilization Survey.
After excluding participants who had missing data on covariates used in the analysis - age, race/ethnicity, income, insurance status and education - the researchers were left with 3,826 participants for their analysis, 481 (13%) of whom were African American, 119 (3%) non-Hispanic Asian, 351 (9%) Hispanic and 2,875 (75%) non-Hispanic white. The participants' mean age was 69 and 2,307 (60%) were female.
After adjusting for confounders, non-Hispanic African American patients (odds ratio, 1.82) and Hispanic patients (OR, 1.77) were significantly more likely than non-Hispanic whites to report not being able to afford their medications.
The new findings weren't a surprise to Dr. Louis Pasquale, director of the Eye and Vision Research Institute of New York Eye and Ear at Mount Sinai in New York.
"Due largely to expenses related to chronic medical therapy, the cost of glaucoma care is $9.2 billion in the United States," said Dr. Pasquale, who was not involved in the study. "Glaucoma does not take a vacation so lapses in glaucoma care can result in vision loss."
"The higher burden of glaucoma in people of color has been well documented," he told Reuters Health by email. "The relative inability of non-Hispanic African Americans and Hispanics to afford glaucoma medications documented in this study represents an important barrier that could compound the burden of vision already experienced in these patient groups. Removing this inequity could result in considerable reductions of visual disability at the population-based level."
SOURCE: https://bit.ly/3hwlToG and https://bit.ly/3tmbqlo JAMA Ophthalmology, online March 3, 2022.
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