Role of Health Insurance Coverage in Women’s Access to Prescription Medicines

Ranji, Usha R.; Wyn, Roberta; Salganicoff, Alina; Yu, Hongjian

doi:10.1016/j.whi.2007.08.004

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Volume 17, Issue 6 , Pages 360-366, November 2007

Role of Health Insurance Coverage in Women’s Access to Prescription Medicines

Usha R. Ranji, MS
- Henry J. Kaiser Family Foundation, Menlo Park, California
- Usha Ranji, MS, is a Senior Policy Analyst at the Kaiser Family Foundations. Her work addresses issues related to women’s health coverage and access to care, with an emphasis on low-income populations.
- Correspondence to: Usha R. Ranji, Henry J. Kaiser Family Foundation, 2400 Sand Hill Road, Menlo Park, CA 94025; Phone: 650-854-9400; Fax: 650-854-4800.
Roberta Wyn, PhD
- University of California, Los Angeles, Center for Health Policy Research, Los Angeles, California
- Roberta Wyn, PhD, is an associate director at the UCLA Center for Health Policy Research. She conducts research in several health care policy areas with a particular focus on access to health insurance coverage and health care for women, ethnic populations, and low-income groups.
Alina Salganicoff, PhD
- Henry J. Kaiser Family Foundation, Menlo Park, California
- Alina Salganicoff, PhD, is Vice President and Director of Women’s Health Policy at the Kaiser Family Foundation. Her work focuses on health policy issues of importance to women, with an emphasis on health coverage, financing, and access to care for underserved women.
Hongjian Yu, PhD
- University of California, Los Angeles, Center for Health Policy Research, Los Angeles, California
- Hongjian Yu, PhD, is the director for statistical support at the UCLA Center for Health Policy Research. His research in statistics has involved mixed generalized linear models, hierarchical models, survey design, and small-area estimation.

Received 24 October 2006; accepted 20 August 2007.

Objective

To examine the effects of health insurance coverage and other factors on access to prescription medicines for non-elderly women ages 18–64.

Methods

Based on a nationally representative telephone survey of adult women in the United States, this study uses multiple logistic regression to determine the factors significantly associated with cost barriers among non-elderly women. The sample for the study includes 1,177 women ages 18–64 who use ≥1 prescription drug on a regular basis. Cost barriers are defined as not filling a prescription or skipping or splitting doses owing to cost. A composite variable of income and health insurance was created to examine the role of insurance in mitigating barriers for women of different income levels. Descriptive analyses report the share of subgroups of women who have faced any of these cost barriers, and logistic regression analyses were used to examine the role of health insurance, income, and other factors in predicting financial access to prescribed medications.

Key Findings

Over half (54%) of non-elderly women reported that they were taking a prescription medicine on a regular basis, and nearly one third (32%) of these women reported experiencing ≥1 affordability barrier in the prior year and had to either forgo or delay a prescription and/or reduce dosages to make medicines last longer because of costs. Uninsured women had the highest odds of facing a cost barrier, regardless of income level. Low-income, uninsured women were nearly 7 times as likely to face a cost barrier to prescription drugs, compared with higher income women with insurance. Even uninsured women with incomes ≥200% of the federal poverty level had 5 times the odds of facing a prescription medicine cost barrier, and low-income, insured women experienced 2 times the odds of a prescription medicine cost barrier, compared with their higher income, insured counterparts.

Conclusion

Lack of health insurance coverage was significantly associated with experiencing cost barriers, regardless of income level, underscoring the critical role that insurance coverage plays in protecting women from out-of-pocket costs and for accessing prescription medicines. Limiting out-of-pocket spending is also important for low-income women who have insurance, because even minimal costs can act as barriers for this group.