When a patient is unable to take their medication, the effects can be devastating.
Our country is facing a healthcare affordability crisis that places the burden of high out-of-pocket costs on seriously ill patients, impeding adherence to their prescribed treatments. Patients often resort to cost-saving measures—such as cutting pills or delaying their next prescription refill—just to make ends meet.
As we highlight in our new Issue Brief on medication adherence, a recent study by the Kaiser Family Foundation found that nearly one in four Americans who take prescription medications say it’s difficult to afford them, and 29 percent of older adults did not take their medicines as prescribed at some point in the past year due to the cost.
Consequences of non-adherence
Not taking the right dose—or abandoning treatment altogether—can exacerbate a patient’s health condition, increase the risk of disease progression, and lead to prolonged hospitalization.
Non-adherence doesn’t just affect individual patients and their loved ones, it also takes a financial toll on our healthcare system and taxpayers.
Research has found that morbidity and mortality associated with poor medication adherence costs $528.4 billion annually. By making it easier for patients to follow their prescription regimens, we can keep people healthier while reducing unnecessary strain on the economy.
The impact of affordability on medication adherence
To improve medication adherence, it’s important to understand why so many people don’t take their prescriptions in the first place. Some patients don’t take their prescribed treatments because they’re wary of side effects or struggle with complicated regimens. However, research has repeatedly found that the primary factor impacting medication adherence is cost.
Many studies show that high out-of-pocket costs reduce the likelihood that patients will initiate treatment. Even among patients who fill an initial prescription, high out-of-pocket costs increase the probability that they will delay refilling their prescription, stop treatment early, skip doses, or cut pills to make their prescriptions last longer.
From our own annual survey of patients, we know that more than 50% of patients who received a grant from the PAN Foundation in 2019 were not taking their medication as prescribed before receiving financial assistance. For the most economically vulnerable patients with incomes of less than $25,000 per year, 64% reported not taking their medications as prescribed.
Other reasons for medication non-adherence—such as a lack of transportation to a healthcare provider or pharmacy—often stem from financial challenges as well.
Policy recommendations to build long-term solutions
There are several approaches to improving medication adherence, including patient education and behavioral support initiatives such as text message reminders to take a medication. But helping Medicare beneficiaries afford their prescriptions is the most effective way to improve adherence long-term, especially for seriously ill patients.
Placing a cap on out-of-pocket prescription costs, spreading cost-sharing obligations more evenly throughout the year, and expanding the Low-Income Subsidy Program are viable, policy-driven strategies that are urgently needed to provide access to treatment and improve medication adherence for economically vulnerable patients. Not only will these strategies enhance patient health and safety, they will also eliminate billions of dollars in unnecessary healthcare costs.
We urge policymakers to consider both the individual and collective consequences of poor medication adherence and take actions to help Medicare beneficiaries with serious illnesses afford the treatments they need.
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