Adherence to Anti-Tubercular Medications in the United States: Insights from MarketScan Data (2016-2021)
Author(s)
Pooja Gokhale, PharmD1, Lorenzo Villa Zapata, PharmD, PhD2.
1PharmD, University of Georgia College of Pharmacy, Athens, GA, USA, 2University of Georgia College of Pharmacy, Athens, GA, USA.
1PharmD, University of Georgia College of Pharmacy, Athens, GA, USA, 2University of Georgia College of Pharmacy, Athens, GA, USA.
Presentation Documents
OBJECTIVES: Tuberculosis (TB) is a prevalent infectious disease and a significant global public health challenge. Adherence to TB treatment is critical to preventing transmission and the emergence of multidrug-resistant TB. This study aimed to evaluate adherence to anti-tubercular medications in the United States.
METHODS: A national retrospective cohort study was conducted using the Merative MarketScan Commercial and Medicaid Claims data from 2016-2021. High adherence was defined as a proportion of days covered (PDC) of ≥ 80%. The four cornerstone drugs of TB treatment - isoniazid, rifampin, ethambutol, and pyrazinamide - were analyzed. Patients with claims for all four drugs were included. PDC was calculated over a 6-month period from the index claim.
RESULTS: After excluding patients without continuous enrollment for 6 months prior to the index claim, 106 patients from the Medicaid database and 197 from the Commercial database were included. In the Medicaid database, 34.9% of patients showed high adherence to isoniazid, while 48.1% showed high adherence to rifampin. In comparison, a higher percentage of patients showed high adherence to ethambutol (64.2%) and pyrazinamide (65.1%). The percentage of patients with high adherence was slightly higher in the Commercial database for isoniazid (40.1%), and rifampin (50.8%). Ethambutol (62.9%), and pyrazinamide (64.9%) showed similar rates of high adherence.
CONCLUSIONS: Overall adherence to anti-tubercular medications is not optimal, with the lowest rates observed among the Medicaid-insured population. Higher rates of adherence to ethambutol and pyrazinamide suggest higher adherence during the intensive phase compared to the continuation phase.
METHODS: A national retrospective cohort study was conducted using the Merative MarketScan Commercial and Medicaid Claims data from 2016-2021. High adherence was defined as a proportion of days covered (PDC) of ≥ 80%. The four cornerstone drugs of TB treatment - isoniazid, rifampin, ethambutol, and pyrazinamide - were analyzed. Patients with claims for all four drugs were included. PDC was calculated over a 6-month period from the index claim.
RESULTS: After excluding patients without continuous enrollment for 6 months prior to the index claim, 106 patients from the Medicaid database and 197 from the Commercial database were included. In the Medicaid database, 34.9% of patients showed high adherence to isoniazid, while 48.1% showed high adherence to rifampin. In comparison, a higher percentage of patients showed high adherence to ethambutol (64.2%) and pyrazinamide (65.1%). The percentage of patients with high adherence was slightly higher in the Commercial database for isoniazid (40.1%), and rifampin (50.8%). Ethambutol (62.9%), and pyrazinamide (64.9%) showed similar rates of high adherence.
CONCLUSIONS: Overall adherence to anti-tubercular medications is not optimal, with the lowest rates observed among the Medicaid-insured population. Higher rates of adherence to ethambutol and pyrazinamide suggest higher adherence during the intensive phase compared to the continuation phase.
Conference/Value in Health Info
2025-05, ISPOR 2025, Montréal, Quebec, CA
Value in Health, Volume 28, Issue S1
Code
PCR248
Topic
Patient-Centered Research
Topic Subcategory
Adherence, Persistence, & Compliance
Disease
SDC: Infectious Disease (non-vaccine), SDC: Respiratory-Related Disorders (Allergy, Asthma, Smoking, Other Respiratory)