Financial Woes Forcing Patients to Roll the Dice

Financial pressures are leading more patients to take potentially dangerous actions with prescription drugs, according a survey from the Consumer Reports National Research Center in which patients were asked about their use of medications and how they cut costs.

The report found that the percentage of patients who reported skimping on medication and other forms of health care rose by 9 percentage points from 39% to 48%, marking the largest increase in 3 years. Of the 2,038 adults contacted this year, 49% said they currently take at least 1 prescription medicine. The average number of drugs individuals reported taking regularly was 4.5.

Of the patients in this group, 48% said they took steps to save money, including the following:

• Putting off a doctor’s visit (21%)
• Delaying a medical procedure (17%)
• Declining a medical test (14%)

Within that same group, 28% took significant risks with their medication to save money, including:

• Not filling a prescription (16%)
• Taking an expired medication (13%)
• Skipping a scheduled dose without asking a physician or pharmacist (12%)
• Splitting pills in half without consent of their doctor or pharmacist (8%)
• Sharing a prescription with someone else (4%)

Concerns over generics persist

On the positive side, generic drug use remains high. Among those who said they took prescription medication, 3 of every 4 of their prescriptions were filled with a less expensive generic drug. However, more than a third of respondents (39%) expressed concerns about generic drugs or had a misconception about them. For example, individuals stated that they thought generics weren’t as effective or safe as brand-name drugs, caused different side effects, or didn’t have to meet the same federal standards.

Interestingly, although a majority of those surveyed said their physicians regularly recommended generic drugs, 41% said their doctor only sometimes—or never—recommended a generic.

Money talks

In terms of costs, communication seems to be lacking, according to the survey, which found that just 5% of respondents said they found out about the cost of a prescribed drug at the physician’s office; 64% found out when picking up the prescription at the pharmacy.

“If a patient can’t afford their medication, that’s something his or her doctor needs to know,” says John Santa, MD, director of the Consumer Reports Health Ratings Center, in a statement. “Doctors should think of themselves as stewards of their patient’s care, and that includes considering their patient’s ability to pay for treatment.”

Most respondents said they had misgivings about the way physicians prescribe medication and how drug companies might influence their decisions. A majority (85%) said they were concerned about drug companies that reward physicians for writing prescriptions for their drugs, and 76% said they were worried about doctors who are paid to give testimonials or serve as spokespeople for drug companies.

Advice for patients

Finally, the report offered the following advice to help patients more effectively navigate the health system during tough economic times:

• If cost is an issue, raise it with your physician when he or she prescribes a medication, especially one you might have to take long-term for a chronic condition. Ask if there is a generic version. If not, ask if there is a generic drug in the same class of drugs that might work as well.
• Talk with your pharmacist about costs. Ask about special discount generic drug programs. Many chain pharmacies offer a month’s supply for about $4 or three months for $10, though restrictions do apply. Your local independent pharmacists might be willing to match those prices.
• Avoid free samples when possible. They’re usually for the most expensive medications that don’t have generic equivalents, and that can cost you when it’s time to fill the prescription.