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February 11, 2015
Even Insured Americans Cut Back on Medications
to Save Money

Atlanta—Even patients with some type of health insurance may avoid strictly following a medication regimen in order to save money, according to a new report.

About one-fifth (18%) of the $263 billion spent on retail prescription drugs in the United States in 2012 was paid out of pocket, and some patients can’t afford the expenses, even if they have government or private insurance, the National Center for Health Statistics reports.

For example, older adults covered by both Medicare and Medicaid, who tend to be poor, are more likely to avoid taking medications as prescribed to save money but less likely to have asked their doctor for a lower-cost prescription than patients covered by private insurance or with just Medicare.

“Some adults offset the cost of prescription drugs by reducing the dosage and frequency of the recommended pharmacotherapy. Other cost-saving strategies include asking providers for less-expensive medications or purchasing medications abroad,” according to the national Centers for Disease Control and Prevention (CDC) report, which used data from the 2013 National Health Interview Survey to update previous estimates on strategies used by U.S. adults aged 18 and over to reduce their prescription drug costs.

Not surprisingly, strategies for reducing prescription drug costs were more commonly used by adults who were uninsured than those who had public or private coverage.

“Lack of health insurance coverage and poverty are recognized risk factors for not taking medication as prescribed due to cost,” the CDC researchers note. “This cost-saving strategy may result in poorer health status and increased emergency room use and hospitalizations, compared with adults who follow their recommended pharmacotherapy.”

The report added that little data exists on whether adverse health outcomes and higher health care costs are also associated with the cost-reduction strategies of alternative therapy use or obtaining prescription drugs from abroad.

To save money, almost 8% of U.S. adults failed to take their medication as prescribed, 15.1% asked a doctor for a lower-cost medication, 1.6% bought prescription drugs from another country, and 4.2% used alternative therapies, according to the NCHS.

That was especially the case among adults too young to quality for Medicare:

• Adults aged 18-64 years (8.5%) were nearly twice as likely as adults aged 65 and over (4.4%) to have not taken their medication as prescribed to save money.
• Uninsured younger adults also were more likely (14.0%) than those with Medicaid (10.4%) or private coverage (6.1%) to avoid taking medication as prescribed to save money.
• Adults in the uninsured cohort also were more likely to have asked their doctor for a lower cost medication (16.5%), to have not taken their medication as prescribed (14.0%), to have used alternative therapies (9.4%), and to have bought prescription drugs from another country (4.2%) to save money, compared with those who had private coverage (14.0%, 6.1%, 3.5%, and 1.0%, respectively) and those who had Medicaid coverage (14.0%, 10.4%, 3.9%, and 0.7%, respectively).
• Overall, 7.2% younger adults delayed filling a prescription to save money, compared with 3.4% of adults aged 65 and over
• The poorest adults—those with incomes below 139% of the federal poverty level—were the most likely to not take medication as prescribed to save money.

Concerns about drug costs go far beyond the uninsured, however, according to the NCHS article, which noted that patients with Medicaid coverage were more likely (10.4%) to skimp on medications for cost reasons than those with private coverage (6.1%).

The study also found that:

• Adults aged 65 and over who had private coverage were less likely to have tried to save money by not taking medication as prescribed (4.0%), compared with those who had both Medicare and Medicaid coverage (6.4%)
• Those who had only Medicare coverage (18.1%) or those who had private coverage (18.2%) were more likely to have asked their doctor for a lower-cost medication to save money, compared with those who had both Medicare and Medicaid coverage (12.9%).


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