A UCLA-led study reveals that insurance programmes like Medicaid and Medicare’s Low-Income Subsidy help improve medication adherence among Black and Hispanic Medicare Advantage enrollees, yet significant disparities remain, highlighting the need for targeted systemic and community-based solutions.
A study led by UCLA Health suggests that diabetes medication adherence remains uneven across racial and ethnic groups, with Black and Hispanic Medicare Advantage enrollees less likely than white patients to take their medicines as prescribed. The analysis, published in JAMA Network Open, examined national health records for 587,000 patients in 2019 and found that overall adherence to diabetes treatment was below 60%, underscoring how difficult it can be for many older adults to stay on therapy consistently.
The researchers said the disparity was widest when patients were using medicines that can be expensive, including insulin and newer therapies such as SGLT2 inhibitors and GLP-1 receptor agonists. They found that support programmes, including Medicaid and Medicare’s Part D Low-Income Subsidy, narrowed those gaps, indicating that insurance help can make a measurable difference when drug costs are a barrier. According to the JAMA Network Open report, the findings point to the need for more insurance-based and community-level strategies to improve adherence among disadvantaged groups.
One result was especially striking: Black patients were less likely than white patients to adhere to metformin, a long-established and comparatively inexpensive drug. That pattern suggests the problem is not explained by price alone. Utibe R. Essien, the study’s lead author and an associate professor of medicine at UCLA’s David Geffen School of Medicine, said clinicians need to understand how health-plan rules and out-of-pocket costs affect whether patients keep taking their medicines, and should help patients connect with financial assistance where possible.
The broader context is sobering. More than 34 million people in the US have type 2 diabetes, and diabetes rates are higher among Black and Hispanic adults than among white adults, according to the UCLA Health summary. Related research in JAMA Network Open has also linked social disadvantage and public insurance with poorer glucose-monitoring outcomes, while other studies suggest that better support in primary care can improve diabetes management. Taken together, the evidence points to a common theme: access to treatment matters, but access alone is not enough unless systems also address the practical and social barriers that shape day-to-day care.
Disclaimer: This content is for informational purposes only and is not intended to be a substitute for professional medical judgment, advice, diagnosis, or treatment.
