More Prescriptions Go Unfilled, is Uncle Sam “Penny Wise?”

The New York Times reports that “One in seven Americans under age 65 went without prescribed medicines in 2007” and that “that figure is up substantially since 2003, when one in 10 people under 65 went without a prescription drug because they couldn’t afford it, according to the Center for Studying Health System Change in Washington, D.C.”

The Times also reported that Laurie E. Felland, a senior health researcher at the center and lead author of the study, noted that because these numbers are from 2007, they may well be higher now due to the recession.

“The people who were least able to afford medicine were often those who needed it most, Ms. Felland said: uninsured, working-age adults suffering from at least one chronic medical condition. Almost two-thirds of them in the survey said they had gone without filling a prescription.”

The affect among those with chronic conditions is particularly disturbing in light of the data on the relative expense of treating chronic conditions, and the additional expense that neglect in treatment can cause. The Department of Health and Human Services (HHS) has reported that

Chronic Conditions Contribute to Higher Health Care Costs

Twenty-five percent of the U.S. community population were reported to have one or more of five major chronic conditions: ·

• Mood disorders
• Diabetes
• Heart disease
• Asthma
• Hypertension

Spending to treat these five conditions alone amounted to $62.3 billion in 1996. Moreover, people with chronic conditions tend to have other conditions and illnesses.

When the other illnesses are added in, total expenses for people with these five major chronic conditions rise to $270 billion, or 49 percent of total health care costs, according to 1996 MEPS data. On an individual level, treatment for the average patient with asthma was $663 per year in 1996, but when the full cost of care for asthma and other coexistent illnesses is taken into account, the average cost was $2,779.

Expenses for people with one chronic condition were twice as great as for those without any chronic conditions. Spending for those with five or more chronic conditions was about 14 times greater than spending for those without any chronic conditions. Persons with five or more conditions also have high hospital expenditures. In New York State during 2002, of the 1.3 million different persons admitted to the hospital, the 27 percent with five or more chronic conditions accounted for 47 percent of all inpatient costs. (emphasis added, footnotes omitted).

Perhaps as we consider the large number of persons with chronic conditions who are not taking prescribed medications, we should also consider a recent five-year retrospective study of almost 5 million California residents which found that “People who have spotty Medicaid coverage are more than three times likelier than those who maintain continuous coverage to be hospitalized for an illness that could have been managed outside the hospital with doctors’ visits and medication.”

Hospitalization is expensive.

Also, as we noted in a recent post, the Kaiser Foundation has shown that many seniors , who account for a great deal of the health expense in this country (but are not included in the the Center for Studying Health System Change report), also cease or diminish the use of their medications as a result of “the donut hole” in Medicare prescription drug coverage—a gap in coverage which leaves many seniors “on their own” for payments of thousands of dollars per year.