YONKERS, NY — As a result of the flagging economy, Americans are making risky tradeoffs that could be dangerous to their health, according to Consumer Reports’ annual prescription drug poll.  Forty-eight percent of Americans who currently take a prescription medicine told pollsters they’d cut health-care costs, for example, by putting off a doctor’s visit or medical procedure, declining tests, or ordering cheaper drugs from outside of the U.S.  That’s an increase of 9 percentage points since 2010.  The full results are available online at www.ConsumerReports.org/health.

The survey also found that to save money, 28 percent of Americans who take medication have resorted to potentially dangerous actions: for example, they skipped filling a prescription (16 percent), took an expired medication (13 percent), or skipped a scheduled dosage without asking a doctor or pharmacist (12 percent).  Larger numbers (35 percent) of low-income Americans took these risky steps.

Doctors could be doing more to insulate their patients from undue expenses.  For example, not all doctors are routinely prescribing generics, which can be a tremendous money-saver; four out of ten respondents (41 percent) said their doctor only sometimes-- or never-- recommends a generic.   “Doctors need to be stewards of their patients’ resource concerns.   When you walk into your doctor’s office, you are a patient, first and foremost, but you are also a consumer, and your doctor should be tuned into this, especially during these tough times,” says John Santa, M.D., M.P.H., director of the Consumer Reports Health Ratings Center.   

Some survey highlights: 

• Doctors are only slightly more likely to recommend a generic substitute for a brand-name medicine than not. Fifty-four percent of those polled said their physician “always” (26 percent) or “usually” (28 percent) suggests generics, versus 41 percent who said “sometimes” or “never.” 
• While generics account for the majority of prescriptions among those taking drugs regularly, 39 percent of Americans reported a concern or misconception about generics.
• Despite the costly burden of prescription drugs, very few doctors raise the issue of cost during their meetings with patients.  Only 5 percent of patients found out the cost of a prescription drug during a doctor visit, while two-thirds (64 percent) first learned about cost when picking up their medicine at the pharmacy.
• The number of Americans taking a medication who said that information about whether a doctor accepts money or gifts from drug companies is very valuable has increased significantly by nine percentage points since 2010 to 43 percent today.   
• Along the same lines, a strong majority (88 percent) of Americans who take a prescription drug harbor some misgivings about the influence of the pharmaceutical industry on the prescribing habits of their doctors.  Nearly three-quarters (72 percent) agreed completely or somewhat that pharmaceutical companies have too much influence on the drugs that doctors prescribe.  Just over half (52%) agreed that doctors are too eager to prescribe a drug rather than consider alternate methods of managing a condition.  And half (49 percent) agreed that the drugs that doctors prescribe are influenced by gifts from pharmaceutical companies.

“Some doctors are still taking money from industry and they may be lagging when it comes to suggesting alternatives to drug therapy, prescribing less expensive generics, and talking to their patients about cost issues.   This is not a time for doctors to cave into industry influence nor is it a good time to be passive about the fiduciary interests of their patients,” says Santa.  

The poll serves as a reminder that a large swath of Americans regularly take multiple prescription drugs to treat their conditions, and the sticker shock associated with paying for all those drugs is taking a toll: 

• Half (49 percent) of Americans currently take a prescription drug, and among them, the average number regularly taken is 4.5 medicines.  Consumers earning less than $40,000 and those aged 65 years or more take the greatest number of prescriptions (5.7 and 5.5 medicines, respectively). 
• Monthly out of pocket spending for those who regularly take a prescription drug is $59, a slight drop of $9 from two years ago. The decline appears to be driven by the increasing use of generics in response to household budget pressures. 

“Our polling suggests that the burden of prescription drug prices is coming down as our medicine cabinets are more frequently filled with generic drugs.   But the costs of multiple prescriptions has proved to be onerous for many Americans, so much so that some consumers are making unhealthy tradeoffs,” said Lisa Gill, prescription drug editor, Consumer Reports Health.  

Some advice for consumers:

• Consumers should not change the dosage of their prescription drugs on their own. If cost is a concern, it’s best for patients to raise the issue with their doctors when they prescribe medication, especially if the drug is being used long term for a chronic condition.  Consumers might also talk to the office nurse or a pharmacist. 
• Ask about the possibility of taking a generic instead of a brand name drug.  Generics use the same active ingredient as brand-name drugs, are regulated in the same manner, and must prove their “bioequivalence,” which means they release the same amount of the drug at the same rate as their brand-name counterpart.
• Pharmacists can be a helpful resource. They can point a consumer to a discount drug program.  They know the pros and cons of drugs and their costs and they likely have a comprehensive record of an individual’s medicines.
• Many chain pharmacies offer a month’s supply for about $4 or a three month’s supply for $10, though restrictions apply.  Local independent pharmacies may be willing to match these prices.
• Avoid free samples when possible because they’re usually available for newer, more expensive medications for which no generic is available, and that can cost a consumer when its time to fill the prescription.
• For more tips, log on to www.ConsumerReports.org/health.

Survey Methodology
The Consumer Reports National Research Center conducted a telephone survey using a nationally representative probability sample of telephone households. A total of 1,226 interviews were completed among adults 18+ who currently take a prescription drug.  Interviewing took place June 2-6, 2011. The sampling error is +/-2.9 percentage points at a 95% confidence level.

Consumer Reports is the world’s largest independent product-testing organization.  Using its more than 50 labs, auto test center, and survey research center, the nonprofit rates thousands of products and services annually.  Founded in 1936, Consumer Reports has over 8 million subscribers to its magazine, website, and other publications.  Its advocacy division, Consumers Union, works for health reform, food and product safety, financial reform, and other consumer issues in Washington, D.C., the states, and in the marketplace.