By Linda A. Johnson
TRENTON, N.J. —
Not taking your medicines as prescribed can hurt your wallet as well as your health and far outweigh any savings on your pharmacy bill.
Not filling prescriptions and even skipping doses can result in serious complications and lead to ER visits and hospital stays, even premature death.
Patients not taking medicine as prescribed cost the U.S. healthcare system roughly $290 billion a year in extra treatment and related costs, research shows. One study estimated those patients pay about $2,000 a year in extra out-of-pocket medical costs.
Nearly three in four Americans don’t take their prescription medicine as directed. Even among those with serious chronic health conditions such as diabetes, about one in three don’t.
To improve patients’ health and rein in medical spending, the National Consumers League is running “Script Your Future,” a three-year campaign with medical and other groups, to educate patients and get doctors and other health workers to discuss it with patients. Since it launched in the spring, more than 100,000 people have signed the league’s online pledge to stick to their medication schedule.
For patients with chronic health conditions — nearly half the U.S. population — not taking medications as prescribed can bring serious consequences:
•Doctors may believe a drug they prescribed for the patient didn’t work and switch to another one that has worse side effects or costs more.
•Deadly viruses such as hepatitis C and bacterial diseases such as tuberculosis, which require daily medicine for many months, can become resistant to the medicine. That can extend treatment for months, force the addition of more-toxic medicines or make curing the illness impossible.
•Patients who don’t always take medicines for high blood pressure and cholesterol problems can suffer a heart attack or stroke, causing disability or death.
Despite the consequences, patient surveys show a variety of reasons for not taking medicines as prescribed, according to Script Your Future spokeswoman Rebecca Burkholder.
The most common reasons are:
•Financial problems/lack of health insurance.
•Complicated or confusing medication schedule.
•Forgetfulness.
•Problems with or fears of side effects.
•Belief the medicine isn’t really needed. This is common with symptomless conditions such as high blood pressure.
Here are some strategies for addressing these problems:
•If you don’t really understand why you were prescribed a drug and the consequences of not taking it, list your questions and talk to your doctor or pharmacist. If you do research on the Internet, stick to reliable websites run by government health agencies, patient advocacy groups, hospitals or universities.
•If you’ve been suffering side effects or worry a new medicine may cause them, talk to your doctor about whether there’s an alternative drug or steps to lessen side effects, such as taking the drug with food or right before bed. Sometimes an additional drug may lessen side effects.
•If you can’t afford your medicine, ask whether your doctor has free samples or there’s a cheaper generic version.
Also, try contacting patient assistance programs run by brand-name drug manufacturers, the industry-backed Partnership for Prescription Assistance at www.pparx.org or by nonprofit groups, including www.patientadvocate.org, www.rxhope.com, www.needymeds.org and www.patientassistance.com. Ask your pharmacy if it participates in any discount prescription card programs.
Price shop for the best deal. Some state health departments have websites for comparison of prices at different drugstores. There are also Internet drugstores with discounted prices, such as www.healthwarehouse.com. Make sure the site has the blue Verified Internet Pharmacy Practice Sites symbol.
•If forgetfulness or confusion is the issue, try pill organizers or reminder devices.
If you just need something to jog your memory, post a reminder card on the kitchen counter or refrigerator door, or set an alarm on your watch or smartphone. You can also buy special vibrating watches for around $100.
Try an inexpensive weekly pillbox divided by time of day from a drug or discount store, or invest in an organizer pill bottle or divided box with an alarm timer that can fit in your pocket or bag. There are even countertop dispensers with individual medication cups that a caregiver can fill for weeks in advance. These devices run from about $30 to several hundred dollars, depending on how sophisticated they are. Some even notify caregivers when the patient misses medicine doses.
There are smartphone applications, some free, that can send text reminders every time you need to take a medicine or refill a prescription. Or you could sign up for a reminder service that sends e-mail or text messages for $5 to $10 per month. More expensive services make automated reminder calls to the patient and, if there’s no response, notify emergency contacts.
Ask your health provider, pharmacist, nurse or insurer for advice. Or check out sites selling these items: www.epill.com, www.medminder.com, www.managemypills.com, www.blueberryrx.com, www.medication-reminders.com or www.rememberitnow.com. Many of these items also are available at www.Amazon.com. Make sure to read the fine print before submitting your credit card information.
Information, wallet prescription lists and other tools to improve medication adherence: www.ScriptYourFuture.org.
Patient advice: www.merckmanuals.com/home/drugs/adherence_to_drug_treatment/adherence_to_drug_treatment.html. —AP
