CDC: Strategies Used by Adults to Reduce Their Prescription Drug Costs

In 2011, Americans spent $45 billion out-of-pocket on retail prescription drugs. Some adults reduce prescription drug costs by skipping doses and delaying filling prescriptions. Some cost-reduction strategies used by adults have been associated with negative health outcomes. For example, adults who do not take prescription medication as prescribed have been shown to have poorer health status and increased emergency room use, hospitalizations, and cardiovascular events. This CDC report analyzes different strategies used by U.S. adults to reduce their prescription drug costs, by age, health insurance status, and poverty status, using data from the 2011 National Health Interview Survey (NHIS). Previous studies have found that more than 48% of Americans took at least one prescription drug in the past month. However, some people do not take medication as prescribed. Adults who do not take prescription medication as prescribed have been shown to have poorer health status and increased emergency room use, hospitalizations, and cardiovascular events. This study provides a baseline to track strategies used by adults to reduce their prescription drug costs on a national level for all adults and for subgroups defined by insurance status and poverty level. This report also contributes to the body of literature on the potential burden of prescription drug costs among vulnerable populations including the uninsured and those who are poor. Adults who were poor, near poor, or uninsured were more likely to not take medication as prescribed to reduce their prescription drug costs. Adults aged 65 and over generally were less likely than adults aged 18–64 to use strategies to reduce their prescription drug costs. Health insurance may, in some cases, result in access to drugs but this might not always be the case, even for those over age 65 who may have multiple forms of coverage (such as Medicare and private insurance, or who may be “dual eligible” for Medicare and Medicaid). Adults aged 65 and over with Medicare-only coverage were more likely than those with private or those with Medicare and Medicaid coverage to ask their doctor for a lower-cost medication to save money. Differences in use of cost-saving strategies were found by insurance status for those aged 18–64. Privately insured adults aged 18–64 were more likely than those with Medicaid coverage to ask their doctors for a lower-cost medication, however they were less likely than those with Medicaid coverage to not take medication as prescribed. Key Findings • Adults aged 18–64 and those aged 65 and over were equally likely to have asked their doctor for a lower-cost medication to save money on prescription drugs (19.8% and 20.3%, respectively). • Adults aged 18–64 were twice as likely to not have taken medication as prescribed to save money (12.6%) compared with adults aged 65 and over (5.8%). • Among adults aged 18–64, uninsured adults (23.1%) were more likely than those with Medicaid (13.6%) or those with private coverage (8.7%) to not have taken medication as prescribed to save money. • Among adults aged 65 and over, those with only Medicare coverage were more likely to ask their doctor for a lower-cost medication to save money (24.9%) compared with those who had private coverage (20.1%) and those with Medicare and Medicaid (14.7%) coverage. Note: This report focused only on cost-related strategies used by adults to reduce their prescription medication costs. There are other barriers to medication adherence including those not related to cost that are not measured in NHIS. (Source: Cohen RA, Kirzinger WK, Gindi RM. Strategies used by adults to reduce their prescription drug costs. NCHS data brief, no 119. Hyattsville, MD: National Center for Health Statistics. 2013.)
http://www.cdc.gov/nchs/data/databriefs/db119.htm#citation