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Many Patients Don't Bring Up Drug Cost Issues

Doctors Often Don't Ask and Their Patients Don't Tell About Drug Cost Concerns
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WebMD Health News

Sept. 13, 2004 -- Many chronically ill older adults never tell their doctor about prescription drug cost concerns or disclose their plans to cut back on prescription medications due to the cost associated with the drugs, according to a new study.

Researchers found that two-thirds of older adults with chronic illnesses such as diabetes, heart disease, and asthma never told their health care provider in advance that they planned to cut back on their medications because of the cost, and more than a third never discussed the issue of prescription drug cost at all.

Previous studies have shown that people concerned with out-of-pocket drug costs often limit prescription drug use and don't take them as directed. Researchers say that because many older adults and people with chronic disease often take many medications, they are especially vulnerable to the pressures of rising drug costs.

Underuse of essential prescription drugs, such as cholesterol-lowering drugs, heart medications, asthma medications, and antipsychotics, has been associated with many negative health effects, including:

  • Increased emergency room visits
  • Admission to a nursing home
  • Hospitalization for serious psychiatric problems
  • Decreased overall self-reported health status

Doctors Don't Ask, Patients Don't Tell

Despite these well-known hazards, researchers say few studies have looked at whether patients discuss prescription drug cost concerns with their health care providers.

In the study, published in the Sept. 13 issue of the Archives of Internal Medicine, researchers surveyed 660 older adults with chronic illnesses who said they had underused medications in the previous year due to cost concerns.

Researchers found that the issue of prescription drug cost was often ignored by both patients and their doctors. Of those surveyed:

  • Two-thirds never told a doctor or nurse in advance that they planned to underuse their medications because of their cost.
  • 35% never discussed the issue of drug cost at all.
  • 66% reported that they had not been asked by their health care provider about their ability to pay for prescriptions.

When asked why they didn't bring up the issue of drug costs, nearly half said they were too embarrassed to have such a conversation or thought the issue wasn't important enough to raise with their doctor.

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