Financial strains keep patients from taking prescriptions as directed

As FiercePracticeManagement reported nearly a year ago, medication noncompliance still poses a major barrier to physicians' ability to get their patients well, according to two unrelated studies about patient medication use (and misuse).

The reasons patients fail to take medications as directed vary, but drug costs are playing a significant role, according to a study released April 9 by the Centers for Disease Control and Prevention (CDC).

In particular, the responses from 33,000 people who participated in the CDC's National Health Interview Survey in 2011 included the following:

  • About 20 percent of adults regardless of age have asked their doctors for a lower-cost treatment.
  • 24 percent of uninsured people did not take prescriptions as recommended, compared with nearly 19 percent of privately insured patients, and 15 percent on Medicaid.
  • 13 percent of adults under 65 reported not taking their medications as prescribed to reduce costs, compared with 6 percent of senior citizens.
  • 6 percent of adults under 65 used alternative treatments to save money, compared with 2 percent of seniors.
  • About 2 percent of all survey participants said they have bought medicine from outside the United States to save money.

"If you're not insured or you face high co-payments, you're going to stretch your prescriptions," said Steve Morgan, an associate professor at the University of British Columbia's School of Population and Public Health in Vancouver, Bloomberg reported. "Even among insured populations, there is this invincibility mindset among the very young. Older people are more likely to adhere to chronic therapies over a longer period of time than younger."

Meanwhile, a separate analysis of more than 250,000 urine samples from Quest Diagnostics reported that about 60 percent of patients failed to take their medications as prescribed--either by skipping medications or combining them with other prescriptions or illegal drugs--during 2012. Although this marks a slight improvement from the 63 percent medication-misuse rate calculated in 2011, experts told Newsworks that the research points to an urgent need for primary care physicians to discuss drug use with patients.

"It points out to me that if you are operating in primary care and you're not having these conversations, you are missing the boat," said Adam Brooks of the Treatment Research Institute in Philadelphia. "Despite the fact that there has been some reluctance to put screening and intervention in primary care, this just speaks to the fact that it's greatly needed."

To learn more:
- read the story from Bloomberg
- see the article from Newsworks
- check out the report (.pdf) from Quest Diagnostics