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Many Chronically Ill Patients Don't Tell Their Doctors That They Limit Use of Prescription Drugs Because of Cost

ROCKVILLE, MD -- September 14, 2004 -- About two-thirds of chronically ill adults who cut back on their medications because of the cost don't tell their doctors in advance, according to a new study funded by the Agency for Healthcare Research and Quality. The study is published in the September 13 issue of the Archives of Internal Medicine.

John D. Piette, Ph.D., and his colleagues from the Center for Practice Management and Outcomes Research at the Veterans Adminstration (VA) Ann Arbor Healthcare System surveyed a panel of 4,055 adults age 50 and older who reported taking prescription medication for diabetes, depression, heart problems or high cholesterol. Of these, 660 patients reported forgoing some medication in the prior year due to cost pressures and two-thirds of this group reported that they did not tell their clinicians in advance. Approximately 35 percent of the 660 patients said that they never discussed medication costs in the prior year with their clinicians.

"It is important that chronically ill patients follow their physician's directions to take medications as prescribed," said AHRQ Director Carolyn M. Clancy, M.D. "We encourage patients and clinicians to discuss potential barriers to their medical care, including the cost of prescription drugs, and discuss possible alternatives such as available drug-cost assistance programs or the use of generic medications."

The researchers found that most patients who failed to talk with their clinicians about medication costs said that none of their providers asked them about possible problems paying for their treatments. Patients also reported that they didn't think their clinicians would be able to help them with this problem or that they were too embarrassed to discuss issues related to cost. Most patients who did discuss the cost of prescription medication with their clinicians found their clinicians to be helpful and received a variety of forms of assistance such as free samples or a change in their regimen to a less-expensive or generic alternative. However, less than one-third of the patients who spoke to their clinicians about the cost of prescription drugs reported being given information about programs to assist patients with medication costs or sources of lower-cost refills.

Source: Agency for Healthcare Research and Quality

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