When Drug Costs Are High, Patients Skip Doses

by birtanpublished on August 23, 2020

A lot of patients don't take their medications as prescribed due to cost issues and this isn't unique to the uninsured with private insurance even a modest co-payment can cause people to skip drug doses that's the topic of this week's healthcare triage there's a logic

To out-of-pocket medical payments they're supposed to make patients think twice before spending money on unnecessary health care when it comes to drugs however they're often preventing people from getting necessary care

Recent data brief from the National Center for Health Statistics said about a quarter of adults who had diagnosed diabetes ask their physician if there was a lower cost medication they could try even if things were working for them

13% of them had not taken their medication as prescribed because of the cost some of these patients were uninsured more than a third of such patients had not taken their medication as prescribed because of the cost that

Was also the case for about 18 percent of those with Medicaid what might be surprising though is that 14% of patients with private insurance went without their medications as well study and diabetes research in clinical

Practice last year examined data on cost related skipping of diabetes medication they found that more than 16 percent of those with diabetes engaged in this practice those who use insulin and those who earn less than $50,000 per year were

More likely to do so such behavior isn't localized the diabetes multiple studies have shown that when more cost sharing is involved patients are less likely to stick to drug therapy this is true when considering birth control as well as the

Treatment of high cholesterol high blood pressure and other chronic care medications it's even true in cancer before the introduction of tyrosine kinase inhibitors or TKIs patients with chronic myeloid leukemia could expect to

Live five to six years after diagnosis these medications taken orally every day can lead to full lifespans they're costly however and need to be taken for the rest of a patient's life in 2013 stacey dousset xena an associate

Professor of health policy of Vanderbilt University School of Medicine and colleagues published a study in which they looked at healthcare plan claims from 2002 to 2011 they wanted to examine adults who had CML and

Who initiated therapy with imatinib the first tyrosine kinase inhibitor they were all patients with private insurance the researchers found that patients with relatively higher monthly co-payments about 53 dollars were more likely to

Discontinue therapy within six months than those with lower co-payments 17 percent versus 10 percent stopping the therapy can lead to recurrence or even death one of the biggest concerns about coming back on medications due to cost

Is that some medications only work well if you take them exactly as prescribed Stacey told me even worse than that in some cases if you take only part of what you're prescribed your disease can change of the drugs no

Longer work for you this can happen in the type of cancer that a mattr name and other TK i's are used to treat more than 8% of all Americans between 18 and 64 have not taken medications as prescribed because of the cost of them even 6% of

Those with private insurance haven't taken recommended drugs because of what they still had to pay this is mainly an American problem a study published in BMJ open compared rates of cost related skipping of drugs among people 55 and

Older in 11 high-income countries most countries had a prevalence lower than 4% the second highest rate was in Canada at 8% this was still less than half the prevalence we see in the United States at almost 17% Canada's single-payer

System sometimes held up as the preferred other model to the American status quo but it's drug coverage isn't so good compared with the rest of the world pharmaceutical coverage is not part of

Canada's Medicare system and differs from province to province still Canadians do better than Americans study and clinical therapeutics about a decade ago specifically compared the rates of costs related non-adherence in the

United States and Canada uninsured Americans were seven times as likely to skip doses of medication those with public or private insurance were still more than twice as likely insurances than enough that seems clear in 2015

Researchers published a study in the journal of General Internal Medicine that looked at medication adherence and cost-saving strategies of those who have met here about 40 percent of this population

Took actions to try to cut their costs some are relatively innocuous asking for free samples for example but more than 3% of those surveyed admitted to buying their drugs from another country and almost three percent bought drugs over

The Internet almost 13 percent split their pills or took less than the prescribed amount to make medications last longer but this is not how medications work with many drugs like a matter nib it can even make

Things worse most of the discussions around the cost of drugs focus on the extreme amounts that the system will have to pay drug companies so that people can get them relatively few discussions focus on the relatively

Smaller amounts we still require of patients to receive them these smaller amounts are still a major barrier to care doctor dousset zina again unfortunately we as a society don't do a good job of making it easier to afford

Care with clear benefit and harder to pay for care that's more questionable if we weighed those trade-offs more I think we could get to a place where drugs that work were affordable for patients and companies were paid for their very high

Value products cost-sharing supposed to lower spending without sacrificing quality it was not meant to prevent patients who need drugs from receiving them hey you enjoyed this episode you might enjoy this other episode on

Regulating drug prices another thing you do to help out the show is like and subscribe down below and go to patreon.com/scishow where you like our research associate jos evans and our surgeon Admiral Sam

Can help make the show bigger and better

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