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Managing Medication Cost Burden: A Qualitative Study Exploring Experiences of People with Disabilities in Canada

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  • Shikha Gupta

    (School of Rehabilitation Therapy, Queen’s University, Kingston, ON K7L 3N6, Canada)

  • Mary Ann McColl

    (School of Rehabilitation Therapy, Queen’s University, Kingston, ON K7L 3N6, Canada)

  • Sara J.T. Guilcher

    (Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, ON M5S 3M2, Canada)

  • Karen Smith

    (Department of Physical Medicine and Rehabilitation, School of Medicine, Queen’s University, Kingston, ON K7L 3N6, Canada)

Abstract

Despite the abundant literature on the burden of rising costs of prescription medications, there is limited research to explore how these costs affect people and the decisions they are forced to make within the context of disability. In this qualitative study we explored strategies adopted, factors influencing, and the impact of some of these strategies to manage the burden of medication cost among persons with disabilities. We interviewed 12 adults with spinal cord injuries living in Canada, using a general inductive approach to analyze the data. We found that before cutting back on medications due to costs, participants generally tried and sought help from the government, employers, and/or their prescribers to improve their drug coverage. The key factors that participants considered while making decisions on the strategies included the cost and perceived importance of medications, their financial status, other competing needs, and their relationship with the prescribers. While some of their efforts were successful, many participants were still not able to obtain their medications as prescribed. In those cases, patients resorted to rationing strategies such as cutting back on medications, other essential needs, or selling assets. These strategies had serious implications on their health, healthcare utilization, and quality of life.

Suggested Citation

  • Shikha Gupta & Mary Ann McColl & Sara J.T. Guilcher & Karen Smith, 2019. "Managing Medication Cost Burden: A Qualitative Study Exploring Experiences of People with Disabilities in Canada," IJERPH, MDPI, vol. 16(17), pages 1-17, August.
  • Handle: RePEc:gam:jijerp:v:16:y:2019:i:17:p:3066-:d:260384
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    References listed on IDEAS

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    1. Piette, John D. & Heisler, Michele & Horne, Robert & Caleb Alexander, G., 2006. "A conceptually based approach to understanding chronically ill patients' responses to medication cost pressures," Social Science & Medicine, Elsevier, vol. 62(4), pages 846-857, February.
    2. Michael Rosbach & John Sahl Andersen, 2017. "Patient-experienced burden of treatment in patients with multimorbidity – A systematic review of qualitative data," PLOS ONE, Public Library of Science, vol. 12(6), pages 1-18, June.
    3. Hanley, Gillian E. & Morgan, Steve, 2009. "Chronic catastrophes: Exploring the concentration and sustained nature of ambulatory prescription drug expenditures in the population of British Columbia, Canada," Social Science & Medicine, Elsevier, vol. 68(5), pages 919-924, March.
    4. Guilcher, Sara & Munce, Sarah & Conklin, James & Packer, Tanya & Verrier, Molly & Marras, Connie & Bereket, Tarik & Versnel, Joan & Riopelle, Richard & Jaglal, Susan, 2017. "The financial burden of prescription drugs for neurological conditions in Canada: Results from the National Population Health Study of Neurological Conditions," Health Policy, Elsevier, vol. 121(4), pages 389-396.
    5. Goldsmith, Laurie J. & Kolhatkar, Ashra & Popowich, Dominic & Holbrook, Anne M. & Morgan, Steven G. & Law, Michael R., 2017. "Understanding the patient experience of cost-related non-adherence to prescription medications through typology development and application," Social Science & Medicine, Elsevier, vol. 194(C), pages 51-59.
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    Cited by:

    1. Ola A. Mirdad & Ghada E. Esheba & Ahmed H. Mousa & Houriah Y. Nukaly & Yosra Z. Alhindi & Nahla H. Hariri & Nahla Ayoub & Safaa M. Alsanosi, 2023. "Over-the-Counter Medication Use among Parents in Saudi Arabia," IJERPH, MDPI, vol. 20(2), pages 1-10, January.

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