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Financial burden from out-of-pocket expenses common in low-income patients with CVD

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Low-income families with a member with atherosclerotic CVD were more likely to have high financial burden regardless of insurance status compared with mid- to high-income families, according to data presented at the American Heart Association’s Quality of Care and Outcomes Research Scientific Sessions.

“We highlight that prescription medications represent a sizeable proportion of out-of-pocket spending on health care,” Rohan Khera, MD, cardiology research fellow at the University of Texas Southwestern Medical Center in Dallas, told Cardiology Today. “Efforts to lower prescription drug costs for patients we see in clinical practices through use of low-cost alternatives and generic medications may be important.”

Researchers analyzed data from 22,521 patients with atherosclerotic CVD from the Medical Expenditure Panel Survey from 2006 to 2015. The number of patients represented 9.9% of U.S. adults and 15% of all U.S. families. Annual inflation-adjusted out-of-pocket expenses were assessed at a patient and family level and compared with annual family incomes.

Families with low income were defined as those with an income less than 200% of the federal poverty limit.

Of the patients with atherosclerotic CVD, 39% were low income. The median income was $39,765 and median annual family out-of-pocket expenses were $2,450.

Out-of-pocket expenses represented 5.5% (interquartile range, 2.6-10.4) of income in mid- to high-income families and 6.4% (interquartile range, 1.3-19.1) of income in low-income families.

Compared with mid- and high-income families, low-income families were more likely to have medical expenses greater than 20% of their income (24.1% vs. 8.1%; OR = 3.6; 95% CI, 3.2-4.1) and greater than 40% of their income (11.2% vs. 1.4%; OR = 9.2; 95% CI, 7.5-11.2).

Although 90% of low-income families in 2006 and 93% of low-income families in 2015 had insurance coverage, patients with insurance had higher out-of-pocket expenses compared with those without insurance or mid- to high-income insurance subgroups, according to the researchers.

“It is critical that we assess if patients and families are forgoing needed care or have adverse health outcomes due to the high cost of health care,” Khera said in an interview. – by Darlene Dobkowski

Reference:

Khera R, et al. Presentation 2. Presented at: American Heart Association’s Quality of Care and Outcomes Research Scientific Sessions; April 6-7, 2018; Arlington, Va.

Disclosures: The authors report no relevant financial disclosures.