DALLAS — The high cost of health care in the United States is a difficult burden for many working class Americans. Yet the question of how to rectify the problem continues to carry heavy political and partisan baggage. As politicians and pundits seemingly debate endlessly on the subject, a disturbing new study finds that millions of Americans with heart disease are forgoing the medication they need to due its high cost.
In all, one in eight U.S. adults with a common heart disease or high likelihood of stroke skip taking their medications, put off filling prescriptions, or take lower daily doses than they should, all because of the ridiculously high prices associated with these medicines. Furthermore, it is three times more common for younger adults under the age of 65 to neglect their medicinal needs than older Americans covered under Medicare.
“The out-of-pocket cost of medications is a huge issue for millions of high-risk patients with cardiovascular diseases such as heart attacks, stroke, angina and other conditions. When faced with the expenses of taking lifesaving medications as prescribed or not taking them because they are too costly, many choose not to take them,” says study author Dr. Khurram Nasir, chief of the division of cardiovascular prevention and wellness and co-director of the Center for Outcomes Research at Houston Methodist DeBakey Heart & Vascular Center, in a release.
Failing to take prescribed medication as often as one should, classified as medication non-compliance, often leads to higher medical costs in the long-term due to an increased chance of emergency room care or hospitalization.
“While non-compliance has several causes, in recent years the rising share of health care costs paid directly by patients has become a concern. We wanted to understand the scope of medication non-compliance due to costs,” Dr. Nasir explains.
The research team analyzed survey responses from 14,279 adults collected via the the National Health Interview Survey between 2013 and 2017. The average respondent’s age was 65, and 44% were women. All included responses came from Americans who had been previously diagnosed with a heart disease, heart-related chest pain, or had experienced a heart attack or stroke.
After compiling all of their research, the study’s authors concluded that over the past year:
- One in eight Americans (nearly 2.2 million nationwide) had not taken their medication as prescribed due to financial concerns.
- Americans under 65 were much more likely (three times) to neglect their heart prescriptions; nearly one in five reported medication non-compliance.
- Within that under 65 age group, women (one in four), people from low-income families (one in three), and those without any health insurance (over 50%) were the most likely demographics to report medication non-compliance.
- Neither race, nor level of education, were found to have a significant influence on whether or not an individual adhered to their medication as prescribed.
- Americans who reported not taking their medications as advised due to money concerns were 11 times more likely to ask about low-cost, cheaper medicine options, and nine times more likely to try alternative, non-prescription therapies in comparison to those who claimed money was not a big concern regarding their health care.
“Patients should not be afraid to speak with their health care provider if they are not able to afford a prescribed medication since there are many lower-cost generic drugs which might also be effective for their condition,” Dr. Nasir says.
The study did not, however, investigate the specific medications patients were being prescribed, or which were more likely to contribute to financial concerns.
“As health care providers, we should also consider advocating for changes in national health care policy, such as capping out-of-pocket expenses for low-income families. We also need to recognize that out-of-pocket medical costs may have a cumulative effect on a patient’s family who may also have difficulty paying for housing, transportation and food. Health care providers can play an active role in working with our local health system and community financial assistance support programs to provide financial assistance and resources to those who need it the most,” Dr. Nasir concludes.
The study is published in the scientific journal Circulation.