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We explored how drug switching impacts adherence measures for common chronic oral medications. Switching between ingredients with the same indication was detected within a 30-day grace period. The proportion of days covered (PDC) and adherent status (cutoff 0.8) for each ingredient was calculated and compared between different censoring approaches: censoring drug switching (PDCswitch), censoring the end of dispensing (PDCend), and fixed 365-day period (PDC365). Overall, 854,380 (15.9%) patients in the Optum ClinFormatics (Optum) and 150,785 (22.0%) patients in the MarketScan Multi-state Medicaid (MDCD) had at least one switch within one year. Compared with PDC365 in Optum, PDCswitch means were higher: 0.85 vs. 0.41 for antihypertensive, 0.82 vs. 0.46 for antihyperglycemics, and 0.84 vs. 0.33 for antihyerlipidemia. Further, the percentages of adherent patients were higher: 95.8% vs. 17.9% for antihypertensive, 85.5% vs. 18.9% for antihyperglycemics, and 72.1% vs. 5.3% for antihyerlipidemia. Significant and modest changes were observed between PDCswitch and PDCend.
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