1966-P: Predicting the Health Benefits of Eliminating Cost-Related Medication Nonadherence among Individuals with Diabetes and Low Incomes

Introduction and Objective: To estimate the long-term implications of eliminating cost-related medication non-adherence (CRN) for morbidity, mortality and health equity among individuals with Type 2 diabetes (T2DM), low incomes and employer-sponsored health insurance (ESI). Methods: We used The Future Elderly Model (FEM), a dynamic microsimulation model, to predict the morbidity, mortality, hospital days, out-of-pocket (OOP) costs and health equity implications of CRN elimination among individuals with T2DM, low incomes and ESI. The FEM uses the Health and Retirement Survey, a first-order Markov modelling approach and Monte Carlo decisions to simulate bi-annual state transitions. Results: With CRN present, individuals with low incomes lived an additional 25.48 years (16.18 disability-free years) on average from the start of the simulation. They spent an average of 53.51 nights in the hospital, and they had an estimated OOP costs of $81,400. Under the CRN-elimination scenario, individuals with low incomes lived an additional 0.12 total and 0.27 disability-free life years on average from the start of the simulation and spent 2.52 fewer days in the hospital. Under the CRN-elimination scenario, the income-based gap in life-expectancy and disability-free life expectancy declined from 1.04 to 0.92 (a 12% reduction) and 1.88 to 1.61 years, (a 14% reduction). Conclusion: CRN elimination was associated with reductions in morbidity and mortality as well as improvements in health equity among individuals with T2DM, low incomes and ESI. Disclosure K. Narain: None. B.C. Tysinger: None. T. Moin: None. O. Duru: Consultant; Current; Boehringer Ingelheim International GmbH. C. Mangione: None.