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Sluggish economy forces Americans to cut corners to pay for medications

Those without prescription drug coverage nearing crisis point

Published: September 2012

Two new Consumer Reports surveys suggest that difficulty paying for health care—including prescription drugs and other medical bills—remains the top financial problem for American households. In the last six months alone, many have cut back on other household expenses or taken potentially dangerous measures with their health to afford their medications. Working-age Americans without prescription drug insurance coverage have been hit hardest and face a deepening crisis since last year.

Cutting back to pay for medication

More than half of people in the survey who took at least one prescription drug said that to pay for their medication they had to reduce other household expenses or change how they manage their finances. Those steps included cutting how much they spent on groceries, entertainment, and family activities, or relying more on their credit cards. And as the table below shows, the problem was particularly severe for people younger than 65 without prescription drug coverage: 84 percent of them said they had to resort to such measures. This is according to a new Consumer Reports Best Buy Drugs national survey of adults who take prescription medications.

Uninsured hit hardest

And a second national survey, the Consumer Reports Index, confirms that problems paying for medical bills and medication remain the most severe financial issues Americans face. That beats problems making mortgage payments or paying other big household bills. It also eclipses other personal economic crises, like losing a job, or facing foreclosure on a home. Americans have consistently ranked their healthcare bills as their most pressing financial problem since at least February 2010.

People younger than 65 without drug coverage were hit hardest this last year, according to the CR Best Buy Drugs survey. They were almost twice as likely to report having financial trouble than people with insurance. For example, they were far more likely to say they had problems paying for medical and medication bills or affording gasoline, and were more likely to have had missed payments on their mortgage or other major bills. They were also more likely to have lost their job or been laid off.

Dangerous steps

Finally, the survey found that many more people this year, compared with last year, who were without drug coverage—81 percent vs. 65 percent—took some action to save money on health care. Many took some potentially dangerous measures too, such as putting off a doctor’s visit, declining a medical test, delaying a medical procedure, failing to fill a prescription, or cutting pills in half without the OK from their doctor or pharmacist.

Those without drug coverage also shelled out more per month for their prescription drugs than those with insurance: $91 a month for those without, on average, vs. $54 a month for those with coverage.

Where doctors fall short

Those without drug coverage also shelled out more per month for their prescription drugs than those with insurance: $91 a month for those without, on average, vs. $54 a month for those with coverage.

Despite the difficulties consumers have paying for medical and medication bills, many consumers are uncomfortable consulting the two professionals who are in the best position to help cut costs—doctors and pharmacists. High numbers of all survey respondents reported being uncomfortable talking to their pharmacist (68 percent) or their doctor (47 percent) about their financial difficulties.

“An important part of a physician’s professional obligations includes assistance navigating stressful financial times—especially when part of the stress is affording the health care a physician orders or provides,” says John Santa, M.D., M.P.H., director of the Consumer Reports Health Ratings Center. “It is especially concerning that half of Americans are uncomfortable sharing these stresses with their doctor. For most physicians, their goal is to take care of the whole patient, not just the portion carrying their wallet.”

Besides not talking about the affordability of medications, most problematic may be that four out of 10 respondents said their doctor sometimes or never recommends generic medications over brand-name drugs, though generic drugs can provide a huge savings, sometimes priced as much as 95 percent less than brand-name medication. And considering that the average person who currently takes any medication takes about four drugs—and 14 percent of people take seven or more—the extra cost of brand-name medicines can add up.

And too, almost no one found out the cost of their medication while at the doctor’s office, although about one in three people said they asked their pharmacist or doctor about getting a less-expensive medication or one covered by their insurance.

Editor's Note: These materials were made possible by a grant from the state Attorney General Consumer and Prescriber Education Grant Program, which is funded by a multistate settlement of consumer fraud claims regarding the marketing of the prescription drug Neurontin (gabapentin).
   

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