Patterns of cost-related medication underuse among Canadian adults with cancer: a cross-sectional study using survey data

Abdel-Rahman, Omar; North, Scott

BACKGROUND: Cost-related medication underuse (CRMU) has been reported within the general population in Canada. In this study, we assessed patterns of CRMU among Canadian adults with cancer. METHODS: This is a cross-sectional study using survey data. We accessed data sets from the 2015/16 Canadian Community Health Survey (CCHS) and reviewed the records of adults (≥ 18 yr) with a history of cancer who were prescribed medication in the previous 12 months. We collected information about sociodemographic features, health behaviours and CRMU, and conducted a multivariable logistic regression analysis for factors associated with CRMU. RESULTS: A total of 8581 participants were eligible for the current study. In the weighted multivariable logistic regression analysis, the following factors were associated with CRMU: younger age (odds ratio [OR] 2.55, 95% confidence interval [CI] 1.79–3.63), female sex (male sex v. female sex OR 0.62, 95% CI 0.44–0.88), Indigenous racial background (Indigenous v. White OR 2.37, 95% CI 1.49– 3.77), unmarried status (OR 1.59, 95% CI 1.09–2.30), poor self-perceived health (excellent v. poor self-perceived health OR 0.36, 95% CI 0.17–0.77), lower annual income (< $20 000 v. income ≥ $80 000 OR 3.08, 95% CI 1.75–5.41) and lack of insurance for prescription medications (OR 2.49, 95% CI 1.77–3.50). INTERPRETATION: The toll of CRMU among adults seems to be unequally carried by women, racial minorities, and younger (< 65 yr) and uninsured patients with cancer. Discussion about a national pharmacare program for people without private insurance is needed.