Evidence map›Paper›PMID 29358417›Full record

SynthesisBMJ open2018

Economic impact of medication non-adherence by disease groups: a systematic review.

Rachelle Louise Cutler, Fernando Fernandez-Llimos, Michael Frommer, Charlie Benrimoj, Victoria Garcia-Cardenas

Abstract readMeta-AnalysisSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in BMJ open, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 444 papers, 17 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
444citing papers in PubMed, 17 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

444 citing papers in PubMed, 17 syntheses or guidelines pooled it.

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  19. Association of medication adherence with treatment preferences: incentivizing truthful self-reporting.The European journal of health economics : HEPAC : health economics in prevention and care · 2025
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384 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors.

Rachelle Louise CutlerGraduate School of Health, University of Technology Sydney, Sydney, New South Wales, Australia.ORCID 0000-0002-3236-8366
Fernando Fernandez-LlimosDepartment of Social Pharmacy Faculty of Pharmacy, Research Institute for Medicines (iMed.ULisboa), University of Lisbon, Lisbon, Portugal.
Michael FrommerSydney Medical School, University of Sydney, Sydney, New South Wales, Australia.
Charlie BenrimojGraduate School of Health, University of Technology Sydney, Sydney, New South Wales, Australia.
Victoria Garcia-CardenasGraduate School of Health, University of Technology Sydney, Sydney, New South Wales, Australia.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveTo determine the economic impact of medication non-adherence across multiple disease groups.

designSystematic review. EVIDENCE REVIEW: A comprehensive literature search was conducted in PubMed and Scopus in September 2017. Studies quantifying the cost of medication non-adherence in relation to economic impact were included. Relevant information was extracted and quality assessed using the Drummond checklist.

resultsSeventy-nine individual studies assessing the cost of medication non-adherence across 14 disease groups were included. Wide-scoping cost variations were reported, with lower levels of adherence generally associated with higher total costs. The annual adjusted disease-specific economic cost of non-adherence per person ranged from $949 to $44 190 (in 2015 US$). Costs attributed to 'all causes' non-adherence ranged from $5271 to $52 341. Medication possession ratio was the metric most used to calculate patient adherence, with varying cut-off points defining non-adherence. The main indicators used to measure the cost of non-adherence were total cost or total healthcare cost (83% of studies), pharmacy costs (70%), inpatient costs (46%), outpatient costs (50%), emergency department visit costs (27%), medical costs (29%) and hospitalisation costs (18%). Drummond quality assessment yielded 10 studies of high quality with all studies performing partial economic evaluations to varying extents.

conclusionMedication non-adherence places a significant cost burden on healthcare systems. Current research assessing the economic impact of medication non-adherence is limited and of varying quality, failing to provide adaptable data to influence health policy. The correlation between increased non-adherence and higher disease prevalence should be used to inform policymakers to help circumvent avoidable costs to the healthcare system. Differences in methods make the comparison among studies challenging and an accurate estimation of true magnitude of the cost impossible. Standardisation of the metric measures used to estimate medication non-adherence and development of a streamlined approach to quantify costs is required. PROSPERO REGISTRATION NUMBER: CRD42015027338.

Indexed as

Cost of IllnessDrug MonitoringCost-Benefit AnalysisDiseaseDrug TherapyHumansadherencehealth economicshealth policypublic healthquality in health care

Identifiers

PMID29358417
PMCPMC5780689

What Socratic holds

Textmetadata
LicenceCC BY-NC
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.