High Costs Make Patients Ditch Drugs

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.

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.

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