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Higher out-of-pocket co-pays cause sick Americans to abandon their prescriptions, according to a new study commissioned by CVS Caremark.

The pharmacy healthcare provider found that patients with a co-pay of $50 are almost four times more likely to abandon a prescription than those paying $10.

According to the study, patients with co-pays of $10 or less have a 1.4% prescription abandonment rate. Those with co-pays between $30 and $40 have a 3.4% rate and those with co-pays of $50 have a 4.7% rate.

"Sticker shock is an important driver of prescription abandonment," said lead author William Shrank, a physician at Brigham and Women's Hospital and a faculty member at  Harvard, who both co-sponsored the study.

And the cost of prescriptions isn’t on the decline. Rather, a 2009 study by the Kaiser Family Foundation found that prescription co-pays for preferred drugs increased 80% from 2000-2009.

In addition to price, Shrank explains that the way prescriptions are filled affects abandonment rates.

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For example, electronic prescriptions, when a doctor submits a prescription over the Internet, are 65% more likely to not be picked up than are hand-written ones. Researchers believe this is because patients with written prescriptions must first bring the request for medications to the pharmacy, while patients with e-prescriptions are not required to take any step to begin the process. Of course, it’s easier to track abandoned e-prescriptions than, for example, paper prescriptions that are never brought in, since there is already a record of them in a pharmacy’s database.

Additionally, patients with first-fill prescriptions are three times more likely to abandon prescriptions than those who are refilling their medication, and younger patients are more likely to abandon their medications than older ones.
According to researchers, if the 3.27% abandonment rate observed during the study period is applied to the 3.6 billion prescriptions filled at pharmacies in 2008, approximately 110 million prescriptions would be abandoned.

Researchers conducted the study by evaluating all prescriptions dispensed at CVS pharmacy locations between July 1 and Sept. 30, 2008. The study is part of CVS Caremark's three-year collaboration with Harvard University and Brigham and Women's Hospital.

"This research gives us new insight into an area of non-adherence that we did not have before and shows we have opportunities to change patient behavior," Larry J. Merlo, president and chief operating officer of CVS Caremark, said in a press release. "We need to be more attentive to reasons why patients may be abandoning prescriptions and work to help them stay on their medications.”

Can’t afford your prescriptions? Check out this MainStreet article that offers some tips for how to cope without healthcare coverage.

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