Medication assistance programs: do all in need benefit equally
Department of Quantitative Health Sciences
Medical Subject Headings
African Americans; Aged; Alabama; Cross-Sectional Studies; Drug Industry; Drug Prescriptions; European Continental Ancestry Group; Female; Humans; Logistic Models; Male; Middle Aged; Social Welfare
Biostatistics | Epidemiology | Health Services Research
OBJECTIVE: To determine if medication assistance programs (MAPs) provided by pharmaceutical companies were used differently by African Americans and Whites.
RESEARCH DESIGN: A cross-sectional survey was conducted among patients of primary care practices from 2005 to 2007 within the Alabama Nonsteroidal Anti-Inflammatory Drug (NSAID) Patient Safety Study.
SETTING: Telephone survey.
PARTICIPANTS: Respondents were 568 African American and White patients reporting annual household incomes < $50,000.
MAIN OUTCOME MEASURE: Use of MAPs.
RESULTS: Of all patients, 12.8% used MAPs, 39.5% were African American, 75.2% were female, 69.1% were aged > 65 years, 79.8% had annual household incomes < $25,000, and 35.5% indicated that their income was inadequate to meet their basic needs. MAPs were used by 11.2% African-Americans and 14.0% Whites. After multivariable adjustment, MAP use was higher among respondents with incomes not adequate to meet basic needs (odds ratio [OR]: 2.19, 95% confidence interval [CI]: 1.17-4.08) but lower among African Americans than Whites (OR: 0.49, 95% CI: 0.25-0.95). Physician characteristics did not independently predict MAP use.
CONCLUSIONS: Overall MAP use was low even among the most vulnerable, and especially among African Americans. As currently used, MAPs may contribute to disparities in medication access.