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Nonadherence to Oral Diabetes Medications Linked With Increased Hospitalizations, Costs

September 17, 2020

Older adults enrolled in a state pharmaceutical assistance program who were nonadherent to prescribed oral antidiabetic medications had double the odds of all-cause and diabetes-related hospitalizations, according to a study published in the Journal of Managed Care & Specialty Pharmacy. 

“Nonadherent patients also had significantly more inpatient hospital visits and longer length of stay than adherent patients,” wrote researchers. 

The retrospective observational study included 9497 older adults with diabetes enrolled in Pennsylvania’s Pharmaceutical Assistance Contract for the Elderly (PACE) program in 2015. Medication adherence was defined as proportion of days covered of 80% or more. 

Some 81% of participants were adherent to oral antidiabetic medication regimens, and 21% underwent hospitalization, according to the study.

In addition to having twice the odds of hospitalizations, nonadherent patients had 27% more all-cause and 21% more diabetes-related hospital visits than adherent patients, researchers found. Length of stay was 24% longer for all-cause hospitalization and 12.7% longer for diabetes-related hospitalization among nonadherent patients. 

Nonadherence to prescribed oral antidiabetic medications was linked with significantly higher  hospitalizations costs, according to the study. All-cause hospitalizations averaged $22,670 with nonadherence, compared with $16,383 with adherence. Diabetes-related hospitalizations averaged $13,518 with nonadherence, compared with $12,634 with adherence. 

“Attention is needed to improve medication adherence among elderly receiving financial assistance to pay their prescriptions to reduce economic burden on the healthcare system,” researchers advised.

Jolynn Tumolo 


Pednekar P, Heller DA, Peterson AM. Association of Medication Adherence with Hospital Utilization and Costs Among Elderly with Diabetes Enrolled in a State Pharmaceutical Assistance Program. J Manag Care Spec Pharm. 2020;26(9):1099-1108. doi:10.18553/jmcp.2020.26.9.1099

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