Cutting Costs in Prescription Drugs Can Lead to
Dangerous Health Outcomes

Sheetal Pasrija, PharmD Candidate 2009

Bernard J Dunn School of Pharmacy, Shenandoah University

Prepared during Consumer Health Information Corporation Clerkship
McLean, VA

A 56 year old accounting manager with diabetes and high cholesterol has started cutting back on his medications including Lipitor. He states, “Don’t tell my wife, but if I have 30 days’ worth of pills, I’ll usually stretch those out to 35 or 40 days. You’re trying to keep a house over your head and use your money to pay all your bills.”

Tough economic times are forcing many consumers to choose between paying for the necessities in life including gas, food, utility bills, and medications. More and more patients are trying to save money on their prescription drugs. Some patients are taking half a dose. Others are taking them every other day. Some only take the medicines they feel are “important”. Some are not refilling their medications and stopping their medicines. They do not realize that saving money now may actually cost more money in the future. Skipping medications can lead to costly serious and life threatening complications.

Percent of Patients Taking Less Medication Than Prescribed

            Stopping medication before running out of it                 29%

            Don’t take full amount of medication prescribed           22%

            Don’t fill the medication prescribed                               12%

Reasons Patients Are Unable to Afford Medications

Increase in Co-payment

According to the Kaiser Family Foundation, the average co-payment on prescription drugs rose from $15 in 2000 to $25 in 2007. This is a $10 difference which can add up quickly when one is taking multiple medications on a monthly basis. Research shows that $20 seems to be the breaking point when patients will think twice before paying for a medication that is more than $20.  

No Prescription Drug Insurance

Another problem for patients is not everyone has drug coverage insurance. There are 47 million people in the United States with no health insurance. This makes it difficult for patients who need to buy prescription drugs to treat long-term diseases. However, without treatment, their conditions could worsen and cost even more money to treat.

Medicare Part D

More and more patients are not filling their prescriptions when they reach the coverage gap in Medicare Part D. This is known as the “doughnut hole”. Patients must pay out of pocket for their prescription drugs when they reach this limit.  During this time period, patients basically do not have prescription insurance coverage. Research has shown that fewer patients in 2007 filled their prescriptions during the time period when reaching the “doughnut hole”.15% of patients stopped taking their medication when reaching the doughnut hole. This data was analyzed based on patients that took drug(s) among eight drug classes used to treat common diseases. Patients who do not fill their prescriptions during this time period are putting themselves at serious risk of medical complications.

Saving Money Now Can Be Costly in the Future

You may feel that you are saving money by skipping medications or taking half the dose needed. However, this only leads to a higher risk for more problems.

Skipping medications now can end up being much costlier for a person since it can lead to hospitalizations. You may also need more medication to correct the complication(s) that may occur from not taking the prescribed dose. For example, you may think that you don’t need to take your blood pressure or cholesterol medications since you don’t feel any different. You don’t feel the effects on your body of avoiding these medications right away. The result of this can actually be very dangerous since this may lead to the disease getting worse.

One patient, a 46 year old unemployed male, presented to the emergency room because he was avoiding his blood pressure medication. He had financial problems at home and experienced some side effects from his blood pressure medication. Skipping his medication caused his blood pressure to skyrocket and also led to major eye problems. He was hospitalized for eight days. The emergency room visit ended up costing him over $10,000.

Major problems can occur when patients do not take medications as prescribed. It can affect a patient health wise and financially.

Tips on Managing Medications Safely

• Do not stop taking medicines without speaking to a doctor or pharmacist about the risks.
• Take advantage of the free counseling services offered at your pharmacy.
• Ask a health care professional to explain the dangers of skipping medications and taking medication doses that are lower than prescribed. 
• Remember to refill medications on time.

Unable to Afford Medications?

If you are unable to afford prescriptions medications, talk to your health care provider who may provide you with other options. Here are some ways to save:

• Talk to a health care provider to see if you qualify for a patient assistance program.
• Ask your physician or pharmacist if there is a generic or cheaper alternative.
• Call the 800# of the pharmaceutical company directly to see if they provide any type of assistance. Visit the company’s website to retrieve contact information such as email and/or phone numbers.   
• Take advantage of retail pharmacies participating in generic drug discount programs including Wal-Mart, CVS/pharmacy, Walgreens, Rite Aid, Target, Safeway, and Kroger.   

Still in Need of Assistance?

These are websites that provide information on various patient assistance programs available to help patients afford medications.

• www.NeedyMeds.org  Site that offers sources for various patient assistance programs, government programs, and programs for children.
• www.RxAssist.com A national program from Volunteers in Health, supported by the Robert Wood Johnson Foundation.
• www.HelpingPatients.org  Site sponsored by PhRMA, the trade association representing pharmaceutical and biotechnology companies

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