Average daily dose, medication adherence, and healthcare costs among commercially-insured @entity1 with @entity239 treated with XXXX .

@entity1 @entity239 @entity2794 @entity4480
OBJECTIVE: What is the relationship between @entity2794 ( @entity2794 ) of @entity4480 , adherence to therapy, and healthcare costs among @entity1 with @entity239 ? METHODS: Employing a retrospective cohort design, this study assessed administrative claims data for commercially-insured @entity239 @entity1 who initiated @entity4480 in 2006. Initiation was defined as a 90-day clean period without access to @entity4480 . Five study cohorts were constructed based on the @entity2794 of @entity4480 , calculated from all prescriptions dispensed over the 12-month follow-up period: <30   mg, 30   mg, 31-59   mg, 60   mg, and >60   mg ( @entity4480 starting dose: 30   mg/day; target dose: 60   mg/day). Medication possession ration (MPR) was used to assess @entity4480 adherence, with MPR >= 0.8 as 'high' adherence. Multivariate regressions were applied to examine the association between @entity2794 , @entity4480 adherence, and healthcare costs (total, inpatient, outpatient, and pharmacy), adjusting for differences in demographic and clinical characteristics between cohorts. RESULTS: Of the 4869 @entity1 with @entity239 , 3% had an @entity2794 of <30   mg, 12% had 30   mg, 21% had 31-59   mg, 46% had 60   mg, and 18% had >60   mg. High adherence to @entity4480 ranged from 16% to 41% across cohorts. Controlling for demographic and clinical characteristics, @entity1 with an @entity2794 of 31-59   mg or >60   mg were more likely to adhere to @entity4480 therapy than those in the 60   mg cohort, while @entity1 in the <30   mg cohort were less likely to adhere to @entity4480 (all p   <   0.05). Total costs were significantly higher for individuals in the 31-59   mg or >60   mg @entity2794 cohorts ( 1834 and  5766) than those maintaining an @entity2794 of 60   mg, as were outpatient ( 1167 and  2275) and pharmacy costs ( 502 and  2983) (all p   <   0.05). @entity1 with an @entity2794 of 30   mg had significantly lower total (- 1770), inpatient (- 1524), and pharmacy (- 827) costs (all p   <   0.05) than those with an @entity2794 of 60   mg. LIMITATIONS: This study is subject to selection bias because some confounders might be unobserved in the administrative claims database. Indirect costs or over-the-counter medication costs were also not available. CONCLUSIONS: @entity239 @entity1 with an @entity2794 of 60   mg of @entity4480 had better adherence than @entity1 with an @entity2794  <=30   mg. @entity4480 @entity1 with an @entity2794 of 30   mg (31-59 or >60   mg) had significantly lower (higher) healthcare costs than those maintaining an @entity2794 of 60   mg.
