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By February 12, 2015Commentary

Brand name and specialty drugs can be expensive.  Almost all employment-based health insurance includes levels of copays on drugs and in some cases a deductible may be applicable as well.  Concern has been raised about whether this cost-sharing may inhibit appropriate use of medications.  A CDC brief based on 2013 survey data explores how adults deal with this issue.  (CDC Brief)   About 18% of drug costs in 2012 were paid out-of-pocket.  According to the survey, 7.8% of adults over age 18 did not take a drug as prescribed to save money.  This might include not filling the prescription or skipping doses.  This tactic was less prevalent among Medicare eligible adults, only 4.4% of whom attempted to cut costs by not using the medication as recommended.  Another 14.7% of all adults said they had asked their doctor for a lower-cost medicine, and here 17% of Medicare beneficiaries had done so.  1.6% purchased drugs from another country to limit their spending and 4.8% used an alternative therapy.  As might be expected, the uninsured had higher rates of using these approaches to avoid spending.  Medicaid patients, who often have no or very low copays, had lower rates, but still higher than the privately insured population.  Poorer adults in general had the highest rates of not taking medication as prescribed and there was a clear association at all income levels, with higher income leading to more compliance with prescriptions.  The survey findings indicate that for a substantial minority of the population, drug costs are a sufficient concern that they may be non-compliant with therapy.  In many cases, this could lead to poorer health outcomes.

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