14 Mar 2017

The U.S. Centers for Disease Control and Prevention (CDC) – Public Health Grand Rounds – recently hosted a webinar on “Overcoming Barriers to Medication Adherence for Chronic Diseases.”  The event brought together a panel of leaders in pharmacy, nursing, medicine, academia, and public health to discuss the burden of medication nonadherence and barriers for adherence among patients with chronic diseases—including HIV/AIDS.

Medication nonadherence manifests in two distinct behaviors: intentional, such as choosing to forgo filling a prescription because of cost, or unintentional, where patients simply forget to take their medication or are unable to manage multiple medications or complex treatment regimens. The panelists highlighted how intervention strategies aimed at medication adherence can positively affect patient health outcomes.

The are many reasons patients fail to adhere to prescribed medication regimens, and often there are several contributing factors, including insufficient educational information, fear of undesired side effects and cost. While the webinar briefly touched on cost as a barrier to access, new survey data demonstrates that cost barriers are a growing public health crisis for millions of Americans.

Americans are routinely forced to make healthcare decisions based on their finances and not what is best for their health. Recent analysis by Prescription Justice of new Commonwealth Fund data shows that 45 million Americans did not fill a prescription last year due to cost – often putting their health at serious risk. Many patients who have some medication, end up rationing it,  stretching out their supply of pills by taking half-doses, which is dangerous because they are not taking the amounts prescribed. A poll commissioned by Prescription Justice found that 1 in 4 Americans had to choose between their medication and a necessity like food or housing costs.

The patient outcomes from non-adherence include mortality: there are an estimated125,000 preventable deaths each year. Although not all are cost-related, the prescription drug price crisis is a contributing factor. According to a survey by the Harvard School of Public Health, half of patients who do not take their prescribed medications get sicker. Unfortunately, medication nonadherence can lead to unnecessary disease complications or progression, resulting in increased medical spending. Annually, the avoidable health care costs of medication nonadherence are estimated at $290 billion, of which $100 billion is for hospitalizations alone.  

The reality of cost-related prescription non-adherence, with millions becoming sick from drug prices, and sometimes dying, is a national disgrace. Americans overwhelmingly agree that drug prices are too high and are ready for President Trump and Congress to take actions to bring down drug prices.

For past blog posts about cost-related prescription nonadherence, click on the links below:




Hepatitis C

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