OBJECTIVES

: This study aimed to investigate the gender disparities in cost-induced medication nonadherence (CIMN) rates among the OECD countries.

METHODS

Unbalanced panel data aggregated at the country level were retrieved from the OECD for the years ranging from 2005 to 2018 for 14 member countries in Western Europe, North America and Australia. CIMN rate was defined as the percentage of adult patients (≥16 years old) reporting skipping prescribed medicines due to costs in the reference year of the respective national patient surveys. Fixed effects regressions controlling for the variation in CIMN rates at the country (or health system), year, and at both country and year levels with robust standard errors were performed to gauge the gender disparities.

RESULTS

: The pooled average of CIMN rates across the included countries was 7.8%, with a gender breakdown of 6.5% and 9.1% for men and women, respectively (p<0.001). The USA was observed to be the country with the highest gender disparity in CIMN rates (6.6 percentage points, or “pp”, the difference between women and men) whereas the UK had the lowest gender disparity in CIMN rates (0.1 pp). Conditioning on the fixed effects, the CIMN rates were, on average, higher for women than men by 2.54 pp (p<0.001). The gender disparity in CIMN rates was exacerbated by an additional 1.2 pp (p=0.027) in health systems with relatively high copayment structures such as the US, which lie at the upper quartile of the cross-country copayment distribution.

CONCLUSIONS

: Women were less likely than men to adhere to medications due to financial reasons, especially in health systems with relatively high medication co-payment by patients. Gender disparities need to be better understood when addressing barriers to medication adherence.