Natala Constantine, 38, of Philadelphia, Pa. injects herself daily with insulin to stay alive. She says she was diagnosed with type 1 diabetes 13 years ago, and reports Lantus worked well for her. With insurance, she says she paid about $30 for a box of 5 pens. Then last year she switched health plans, and she explained her new plan would not cover Lantus, and instead moved her to Levemir, the plan's preferred insulin. Constantine tried it, had trouble using it, and wanted to switch back to her old drug.

Constantine was left with few choices. She says that her old insulin would cost several hundred dollars for a box of 5 pens if she paid for it entirely out of her pocket, now that it was no longer covered by her plan. That was unaffordable. So, faced with this burdensome financial prospect, Constantine found a Canadian pharmacy that would mail a box of 5 pens of Lantus for about $200 U.S. dollars per month, plus shipping. (Good to know: In most cases, importing drugs from outside the U.S. is technically illegal under U.S. law, and Consumer Reports does not advise that people take this action because once the medication is shipped, neither the Canadian government nor the U.S. Food and Drug Administration will take responsibility for its safety. Medication shipped from other countries may also be subject to lengthy delays at U.S. borders.)

Constantine isn’t alone in this problem of having her drug prices increase substantially. In a Consumer Reports Best Buy Drugs nationally representative telephone poll of more than 2,000 adults who take a medication, we found that nearly one-third of people experienced a price hike in the last year on at least one of their medications; paying an average $63 extra for a drug they routinely take. That amounts to people shelling out at least $2 billion extra last year, out of their pockets, for drugs they take all the time.

The problem with forking over the additional cash is that it hurt people in other ways—people were more likely to stop taking their medication; they also skipped filling prescriptions, or didn’t take the prescribed dosage; split pills without contacting their doctor or pharmacist first, took expired meds or even shared prescription drugs with other people, compared to those whose drug costs remained steady.

This infographic explains how drug prices increase

Sometimes, the cutbacks weren’t limited to refills and dosages. Desperate to afford their prescriptions, our survey found that people sacrificed in other potentially detrimental ways. They skimped on groceries. They also reported relying more heavily on credit cards and putting off paying other bills. One in 10 people facing higher medication costs said they postponed retirement in order to maintain their healthcare coverage.

And where people were dealing with high drug costs, other financial setbacks weren’t far behind. More than one out of four people whose drug costs spiked also reported experiencing a costly medical event. They were also more likely than those not facing higher costs to report that they couldn’t afford medical bills, missed major bill payments, or even lost their health coverage.

It’s a grim scenario some doctors say they are all too familiar with. "As physicians all too often we are seeing the situation where we prescribe a medication and a patient says ‘doc, I just can’t afford it.’ We hear that all the time,” says Wayne Riley, M.D., past president of the American College of Physicians.

While too many doctors still aren’t talking about drug costs with their patients, others are not only acknowledging the financial pressures their patients face, but also pushing for cost-lowering solutions. "Patients and the general public are bewildered and extremely frustrated. More needs to be done to stem the rise in prescription drug prices and costs to patients,” adds Riley.

Pharmacists are worried too, seeing the everyday effects of not being able to afford medications. Says Beverly Schaefer, RPh, co-owner of Katterman's Sand Point Pharmacy in Seattle, "More and more I'm seeing that consumers are becoming acutely aware of rising drug prices. They are stretching doses, seeking alternatives, asking more questions of their doctor and pharmacist, and sometimes refusing prescriptions or asking for a less expensive treatment option.”

The Way To Save On Your Prescription Drugs: Speak Up

Editor's Note: This article also appeared in the August 2016 issue of Consumer Reports magazine.

Funding for the preparation of this article was provided in part by the Atlantic Philanthropies and by a grant from the state Attorney General Consumer and Prescriber Education Grant Program, which is funded by the multistate settlement of consumer fraud claims regarding the marketing of the prescription drug Neurontin (gabapentin).