Patients Are Abandoning Their Prescriptions at Higher Rates Than Ever Before
By Barby Ingle
I decided to talk about this topic because I am personally experiencing this and hearing from multiple other patients. We are not alone in not being able to afford our medications, but I did find something to help and wanted to make sure that this information gets out to others who need proper, cost contained, and timely access to care. Last year I had my first experience with abandoning a prescription at the pharmacy. I was filling a first-time script for an inhaler-Bronchodilator medication. I developed asthma symptoms and was not able to afford the medication when I went to pick it up the first time. When my PCP gave me the script he also gave me 2 free samples in his office. He warned me that it could be expensive. Even with insurance, my portion of the cost was more than $100 and I just couldn’t afford it. So, I told them to put it back on the shelf. My Walgreens pharmacist suggested that I google free savings programs like – ScriptSave® WellRx to see if they had any savings for the medication I needed.
It turned out I did find a savings card online that helped save on this medication and was able to fill the script after all. I would have never thought of doing something like this without the suggestion of my amazing pharmacist. I thought for years, I have insurance so I must use the insurance. As it turns out insurance coverage does not necessarily mean low-cost prescription meds. The savings programs can work well for insured people with high out-of-pocket costs like me.
This year I have faced this situation two more times, one with a medication I was taking daily for years and the co-pay price went up so high this year that without a savings card, I would not be able to afford the monthly medication. The other medication, I had to abandon because I was unable to afford the medication even with the savings program although it did provide 50% off what my insurance was going to cover. Never the less, it was worth the look to see if I could find one. My provider had to substitute the mediation for a different medication that I could afford, but I am not sure if it worked as well as the one he originally prescribed would have for me. I know how awful (and embarrassing) it feels to have to abandon the mediation at the pharmacy while you work to come up with a way to afford it and know that you may never be able to pick it up. Now, I have my pharmacist price the medication with insurance covering it and through the ScriptSave WellRx card program to see which is less expensive.
Recently a study was published by Annals of Internal Medicine. The study showed a direct correlation between the amount of a patient’s out-of-pocket co-pay and the likelihood of abandonment. They concluded that when patients have a copay over $50 that they were four times more likely to abandon their prescription than patients who only owed $10. When it comes to taking medications for acute and chronic conditions, it is important to follow all prescription instructions. All non-adherence can lead to major challenges such as conditioning worsening, increase in negative medication side effects, therapeutic failure, increase in medical costs, and in some cases death. The better we work to understand the causes of abandonment and the ways non-adherence to instructions that come with our medications the better our health will be.
This is not a new issue for pharmacies, but as it becomes more common over the past few years. Some of the reasons for abandonment of medications at the pharmacy include younger age, e-prescriptions, drug strength, taking the medication for the first time and not understanding why the medication was prescribed. A 2008 Harvard prescription abandonment study suggested that opiates, anti-platelets and statins were the least likely to be abandoned, while insulin and proton pump inhibitors were more likely to be abandoned. However, cost is the most common reason that I hear about and have experienced myself.
For me it came down to the co-pay I was required to pay for the medication. As with me, studies show that the higher the patient responsibility financially, the greater the risk of prescription abandonment. The second highest reason for abandonment is younger customers who have less financially and along with first time prescriptions they may be warier about the type of medication or simply do not want to take it.
Because financial constraints on patients is the most common reason patients abandon their prescriptions, tools are needed to assist patients in getting the medications they need. The take away for me is that prescription discount cards and pharmaceutical coupons can increase medication compliance, increase patient health, and lower overall costs of medical care. I know that by getting the costs down for my medications I can pick them up and I’m more likely to comply with the instructions. I am doubly insured through a group health plan/PPO through my husband’s insurance as well as having Medicare as my secondary. If I am having trouble financially with my personal costs and my co-pays I know others must be as well. I love being able to pass on vital financial savings to others and know that the types of programs offered in the prescription savings programs is one great tool for the chronically ill population. But it is also available to those who have an acute situation and need an antibiotic that they didn’t know to budget for that month. The program I used personally was free. I wasn’t sure how it was going to work the first time I used it, but the pharmacist just said print the savings card and bring it back. So, that is what I did. He did the rest for me. He knew exactly how to ring it into their register and didn’t seem to bat an eye or look down at me for using a savings program to get the medication I need.
ScriptSave WellRx allows you to compare what the price will be at different pharmacies in the area near where you live, and search for the best discount on the medication. It is quick and easy to use and their program is accepted at more than 60,000 pharmacies across the country. I was able to download the card and print it, but they also have a mobile app for Apple and Android for those who prefer everything digital. They offer an average savings of 45% off the prescription cost and some of their medications are eligible for savings of up to 80%.
Understanding the vital role that prescription savings programs plays in medication adherence for the un- and under-insured chronically ill population is a must. I have used free savings cards in the past and when I run into this situation of being under-insured I will use them again because it is free and easy to check, and saving money is always a good thing when you live with a chronic disease.
reprint similar to my original article on Pain News Network