Out-of-pocket prescription medicine expenditure amongst community-dwelling adults: Findings from the Irish longitudinal study on ageing (TILDA) in 2016
Background: The number of prescription medicines prescribed to older adults is increasing in Ireland and other countries. This is leading to higher out-of-pocket prescription medicine expenditure for older adults, which has several negative consequences including cost-related non-adherence. This stu...
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Elsevier
2025-03-01
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| Series: | Exploratory Research in Clinical and Social Pharmacy |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S266727662500006X |
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| author | James Larkin Ciaran Prendergast Logan T. Murry Michelle Flood Barbara Clyne Sara Burke Conor Keegan Fiona Boland Tom Fahey Nav Persaud Rose Anne Kenny Frank Moriarty |
| author_facet | James Larkin Ciaran Prendergast Logan T. Murry Michelle Flood Barbara Clyne Sara Burke Conor Keegan Fiona Boland Tom Fahey Nav Persaud Rose Anne Kenny Frank Moriarty |
| author_sort | James Larkin |
| collection | DOAJ |
| description | Background: The number of prescription medicines prescribed to older adults is increasing in Ireland and other countries. This is leading to higher out-of-pocket prescription medicine expenditure for older adults, which has several negative consequences including cost-related non-adherence. This study aimed to characterise out-of-pocket prescription medicine payments, and examine their relationship with entitlements, multimorbidity and adherence. Methods: This cross-sectional study used 2016 data from a nationally-representative sample of adults in Ireland aged ≥50 years. Descriptive statistics and regression models were used to describe out-of-pocket prescription medicine payments and assess the association between out-of-pocket prescription medicine payments and the following variables: healthcare entitlements, multimorbidity, and cost-related non-adherence. Results: There were 5,668 eligible participants. Median annual out-of-pocket prescription medicine expenditure was €144 (IQR: €0–€312). A generalised linear model showed that, amongst those with out-of-pocket prescription medicine expenditure, having fewer healthcare entitlements was associated with 4.74 (95%CI: 4.37–5.15) times higher out-of-pocket prescription medicine expenditure. Overall, 1.7% (n = 89) of participants reported cost-related non-adherence in the previous year. A multivariable model examining cost-related non-adherence found a significant association only for those prescribed 4–5 regular medications (compared to 3 medications) (OR: 1.87, 95%CI: 1.02–3.42). Conclusions: Those with entitlements to subsidised prescription medicines had much lower out-of-pocket prescription medicine expenditure. This highlights the benefits of expanding healthcare entitlements and ensuring uptake of entitlements by those with eligibility. |
| format | Article |
| id | doaj-art-0c892ddf05ef4d4a9fc53edd5d0b10c2 |
| institution | OA Journals |
| issn | 2667-2766 |
| language | English |
| publishDate | 2025-03-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Exploratory Research in Clinical and Social Pharmacy |
| spelling | doaj-art-0c892ddf05ef4d4a9fc53edd5d0b10c22025-08-20T02:00:41ZengElsevierExploratory Research in Clinical and Social Pharmacy2667-27662025-03-011710056510.1016/j.rcsop.2025.100565Out-of-pocket prescription medicine expenditure amongst community-dwelling adults: Findings from the Irish longitudinal study on ageing (TILDA) in 2016James Larkin0Ciaran Prendergast1Logan T. Murry2Michelle Flood3Barbara Clyne4Sara Burke5Conor Keegan6Fiona Boland7Tom Fahey8Nav Persaud9Rose Anne Kenny10Frank Moriarty11School of Pharmacy and Biomolecular Sciences, RCSI University of Medicine and Health Sciences, Dublin, Ireland; Department of General Practice, RCSI University of Medicine and Health Sciences, Dublin, IrelandSchool of Pharmacy and Biomolecular Sciences, RCSI University of Medicine and Health Sciences, Dublin, IrelandSchool of Pharmacy and Biomolecular Sciences, RCSI University of Medicine and Health Sciences, Dublin, IrelandSchool of Pharmacy and Biomolecular Sciences, RCSI University of Medicine and Health Sciences, Dublin, IrelandDepartment of Epidemiology and Public Health, School of Population Health, RCSI University of Medicine and Health Sciences, Dublin, IrelandCentre for Health Policy and Management, School of Medicine, Trinity College Dublin, Dublin, IrelandEconomic and Social Research Institute, Dublin, IrelandData Science Centre, School of Population Health, RCSI University of Medicine and Health Sciences, Dublin, IrelandDepartment of General Practice, RCSI University of Medicine and Health Sciences, Dublin, IrelandDepartment of Family and Community Medicine, University of Toronto, Toronto, Ontario, Canada; MAP Centre for Urban Health Solutions, St Michael's Hospital, Toronto, Ontario, CanadaThe Irish Longitudinal Study on Ageing, Trinity College Dublin, Dublin, IrelandSchool of Pharmacy and Biomolecular Sciences, RCSI University of Medicine and Health Sciences, Dublin, Ireland; The Irish Longitudinal Study on Ageing, Trinity College Dublin, Dublin, Ireland; Corresponding author at: School of Pharmacy and Biomolecular Sciences, RCSI University of Medicine and Health Sciences, Dublin, Ireland.Background: The number of prescription medicines prescribed to older adults is increasing in Ireland and other countries. This is leading to higher out-of-pocket prescription medicine expenditure for older adults, which has several negative consequences including cost-related non-adherence. This study aimed to characterise out-of-pocket prescription medicine payments, and examine their relationship with entitlements, multimorbidity and adherence. Methods: This cross-sectional study used 2016 data from a nationally-representative sample of adults in Ireland aged ≥50 years. Descriptive statistics and regression models were used to describe out-of-pocket prescription medicine payments and assess the association between out-of-pocket prescription medicine payments and the following variables: healthcare entitlements, multimorbidity, and cost-related non-adherence. Results: There were 5,668 eligible participants. Median annual out-of-pocket prescription medicine expenditure was €144 (IQR: €0–€312). A generalised linear model showed that, amongst those with out-of-pocket prescription medicine expenditure, having fewer healthcare entitlements was associated with 4.74 (95%CI: 4.37–5.15) times higher out-of-pocket prescription medicine expenditure. Overall, 1.7% (n = 89) of participants reported cost-related non-adherence in the previous year. A multivariable model examining cost-related non-adherence found a significant association only for those prescribed 4–5 regular medications (compared to 3 medications) (OR: 1.87, 95%CI: 1.02–3.42). Conclusions: Those with entitlements to subsidised prescription medicines had much lower out-of-pocket prescription medicine expenditure. This highlights the benefits of expanding healthcare entitlements and ensuring uptake of entitlements by those with eligibility.http://www.sciencedirect.com/science/article/pii/S266727662500006XHealth economicsHealth policyEntitlementsPolypharmacyMedicinesHealth care costs |
| spellingShingle | James Larkin Ciaran Prendergast Logan T. Murry Michelle Flood Barbara Clyne Sara Burke Conor Keegan Fiona Boland Tom Fahey Nav Persaud Rose Anne Kenny Frank Moriarty Out-of-pocket prescription medicine expenditure amongst community-dwelling adults: Findings from the Irish longitudinal study on ageing (TILDA) in 2016 Exploratory Research in Clinical and Social Pharmacy Health economics Health policy Entitlements Polypharmacy Medicines Health care costs |
| title | Out-of-pocket prescription medicine expenditure amongst community-dwelling adults: Findings from the Irish longitudinal study on ageing (TILDA) in 2016 |
| title_full | Out-of-pocket prescription medicine expenditure amongst community-dwelling adults: Findings from the Irish longitudinal study on ageing (TILDA) in 2016 |
| title_fullStr | Out-of-pocket prescription medicine expenditure amongst community-dwelling adults: Findings from the Irish longitudinal study on ageing (TILDA) in 2016 |
| title_full_unstemmed | Out-of-pocket prescription medicine expenditure amongst community-dwelling adults: Findings from the Irish longitudinal study on ageing (TILDA) in 2016 |
| title_short | Out-of-pocket prescription medicine expenditure amongst community-dwelling adults: Findings from the Irish longitudinal study on ageing (TILDA) in 2016 |
| title_sort | out of pocket prescription medicine expenditure amongst community dwelling adults findings from the irish longitudinal study on ageing tilda in 2016 |
| topic | Health economics Health policy Entitlements Polypharmacy Medicines Health care costs |
| url | http://www.sciencedirect.com/science/article/pii/S266727662500006X |
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