Many Skip Doses of Rx Drugs to Save Money

Sept. 27, 2011 -- Robert Schwartz, MD, recently got an email from a patient he was treating for high blood pressure. In the email, the patient told Schwartz that at $130 month, the cost of his prescription blood pressure drug was too steep.

Schwartz, a professor and chairman of family medicine and community health at University of Miami School of Medicine, made some calls and found a more affordable solution for his patient.

This is how it should look, but as the economy lags, growing numbers of people may be cutting corners with prescription medications and not telling their doctors about it.

According to a new poll of 2,038 adults by Consumer Reports, many are putting off doctor's visits, necessary medical procedures, and tests.

In addition, many people do not fill their prescriptions, take expired pills, skip doses, or split pills -- all to lower costs.

"The economy is taking its toll on consumers' health, not just their pocketbooks," says Lisa Gill, the editor of prescription drugs for Consumer Reports.

"They are cost cutting and in dangerous ways, especially with prescription medications," she says.

Schwartz agrees. "I see this type of thing every day," he says. "You explain to patients that cutting back on drugs or cutting pills in half is not a good thing. It's a constant duel."

Cost-Cutting Measures

So what are people doing to save a buck?

According to the survey:

• 16% said they hadn't filled a prescription.
• 13% reported taking an expired drug.
• 12% skipped a dose without first running it by their doctor.
• 8% split pills without direction from their doctor or pharmacist.
• 4% shared a prescription with someone else.

The sampling error in the survey is plus or minus 2.9%.

"They are doing many of these things to save money because they are struggling with medical costs," Gill says. "This fact really hit us over the head."

Doctors can find out the costs of medications in advance, she says.

"If a doctor doesn't have a discussion with a patient about cost in advance, the patient may pick up their prescription that first time, but will be less likely to go back for a refill," Gill says.

Just shy of 50% of people polled said they took at least one prescription medicine this year. On average, participants took 4.5 such drugs on a regular basis. Of these, only 5% said they left their doctor's office with information about cost. Fully 64% learned the cost when they picked up their medication at the pharmacy.

Cost should be a consideration when prescribing medications, especially those that must be taken for the long run, she says.

Generic vs. Brand Name

Some of the responsibility may fall on patients. "Ask if there is anything else in the same class of drugs that may work as well that is generic," Gill tells WebMD.

But some people may feel embarrassed to tell their doctors that they can't afford their medications, Schwartz says.

"Many prescription medications are very expensive, so that is part of the problem. And not enough people are using generics," he says. Forty-one percent of people polled said that their doctor recommended generics "sometimes or never."

Generic drugs are identical in chemical structure to their brand-name counterparts. They cost less and work as well as the brand-name drug. In most states, pharmacists must substitute generic drugs for brand-name drugs unless the prescribing doctor tells them to do otherwise.

In the new poll, 75% of people said that their prescriptions were filled with a generic. Close to 40% of these patients expressed concern -- and misconceptions -- about the use of generics. Misconceptions included believing that generics were not as good as the brand-name drug.