Nearly 8 percent of Americans are not taking their
prescription drugs as indicated by a physician because they can’t afford to pay
In a recent study, the Centers
for Disease Control and Prevention found Americans are using a number of
strategies to manage the high cost of medications. Some methods of saving money
are safer and better for people’s health than others.
The study found that 15 percent of U.S. adults have asked
their physician for a lower-cost medication as an alternative. However, almost
2 percent have purchased drugs from a foreign country where the medications may
or may not be regulated, and an additional 4 percent have used alternative
medicines while 7.8 percent just skipped taking the drugs altogether.
Some Americans did take their medications, but not at the
frequency or dosage prescribed. The study found this to be true in adults
younger than 64 years of age with 5.3 percent admitting they had skipped doses
and 5.6 percent taking less medication than recommended to save money.
It’s common knowledge in the medical community that patients
are not taking their medications as prescribed, said Dr. David Cook, senior
vice president of population health management at Novant Health. Population
health is a health care approach that aims to keep people healthy and reduce
inequities in access to health care provided to different populations.
“In some cases, doctors will write a prescription for a
certain drug, but the patient’s insurance policy will offer different
coverage,” Cook said. “The physician will have no idea that the cost of the
drug has changed.”
Sometimes it’s the expense of the drug that causes patients
not to use it, but other times patients just don’t understand why they need a
medication, Cook said.
Cook said that disparities in health care can also contribute
to patients not taking required medications. “Doctors will prescribe medicines
asking patients if they understand why,” he said. “Patients will nod ‘yes’ when
they really don’t understand why they need the drug.”
Some patients will not ask questions and doctors will assume
they understand based on their behavior, Cook explained. This lowers the fill
rates for prescriptions and accounts for about 10 percent of patients, he said.
Not taking medications as prescribed can have serious
consequences. If a person has diabetes,
not treating the condition with appropriate medicine can cause damage to a
person’s heart, blood vessels, eyes and kidneys, for instance. Cook warned
starting a drug therapy and then stopping it – whether because of cost or
another reason – can also cause serious harm.
It also greatly impacts health care costs. “It’s a multimillion-dollar
problem in America,” Cook said.
For example, Cook said dialysis is already a huge problem in
the United States. If people aren’t managing their diabetes properly now, over
the long run we’ll become sicker as a nation, he said.
In the study, skimping on medication over financial concerns
was particularly prevalent among the poor and uninsured. The CDC report said 14
percent of adults aged 18-64 without insurance had not taken their medication
as prescribed compared to 6 percent with insurance and 10 percent for those
eligible for Medicaid.
Poor adults, or people with incomes below 139 percent of the
poverty level, were the most likely Americans to skip on their medicine,
according to the researchers.
The CDC researchers used data gathered from the2013 National
Health Interview conducted by the U.S. Census Bureau. Americans spent
$271.1 billion on prescription drugs in 2013, according to U.S. Centers for
Medicare and Medicaid Services.
Cook said there are ways for doctors to get more engaged in
patient health. Some of the change is behavioral such as a heightened awareness
and communication with patients. Other methods involve patient engagement tools
such as smartphone applications reminding patients about medications and
follow-through by patient care coordinators.
Doctors too can stay informed on what deals have been struck
between insurers and manufacturers of medicine in order to know what is
effective and affordable to patients.
And patients should take responsibility for their own health
care, Cook said. Consumers need to speak up, raise questions, call their
doctors and mention if they encounter issues with affordability or access to
How can you help lower your drug costs?
- Ask your doctor whether there is a generic
equivalent. Let your doctor know that cost as well as effectiveness of the
- Ask your doctor if the pills can be safely split
in half. The doctor would prescribe a double dose that could be easily cut in
half at the score line.
- Compare prices among drug stores, big box
retailers and mail-order pharmacies.
- Check to see whether the pharmaceutical company
offers help paying for the drug. Some major drug companies offer free
medication to consumers who cannot afford the medication.
- If eligible for Medicare, choose a plan that
offers additional drug benefit for the gap coverage or “donut-hole.”