The Perceptions of Patient Copayment on the Reported Adherence to Prescription Medication

BACKGROUND: In South Africa, a large proportion of the population is dependent entirely on the publicly funded system for healthcare, while private funding covers only a small percentage of those who can afford to pay for health insurance or out-of-pocket payments. Non-compliance to medical treatment is a well-known problem and may lead to an increase in healthcare costs.

OBJECTIVES: To investigate how the perception of prescription copayments influences medication use and the effect of this on safe and correct medicine usage

METHODS: The study was conducted with a sample of patients from the Umbilo suburb of eThekwini, South Africa. Participants were members of a medical scheme and completed a questionnaire after informed consent. The questionnaire design included an eight-item scale to ascertain the degree of concern regarding prescription costs. Quantitative data were analysed using descriptive statistics; associations between household characteristics and outcomes were explored using odds ratios and chi square analysis.

RESULTS: Overall 82% of the participants reported that prescription cost was a major factor that influenced medication collection. The association between demographic data and concern scale was assessed and revealed that participants had an increased concern with meeting prescription costs (OR 1.73, 95% CI 0.66-4.52). Most (93%) of the participants with a salary less than ZAR10 000 indicated a concern with prescription costs (chi square=21.7, df=2, p<0.05).

CONCLUSION: The study indicated that prescription cost posed as a barrier to medication adherence as the copayment affected patients’ decisions to continue optimal treatment.