One in twelve on medications didn’t take them as prescribed due to cost

February 6, 2024

This is a repost from June, 2023 - a topic that continues to be important

Source: Centers for Disease Control and Prevention June, 2023 LINK

The Centers for Disease Control and Prevention (CDC) published data last year showing that 8.2% of adults under 65 who were prescribed a medication in 2021 reported that they either did not take the medication, took lower doses than recommended, or delayed filling a prescription due to concern about cost. This data is from the National Health Interview Survey, a high quality representative national survey of almost 30,000 adults. About 60% of adults who were surveyed were prescribed at least one medication during the calendar year. While nonadherence was highest (22.9%) in those who were uninsured, it was 6.5% in those who reported that they were privately insured. It was 3.9% (1 in 25) for individuals with a household income greater than 400% of the federal poverty level, about $120,000 for a family of 4.

Most research studies which count pills suggest that non-adherence is substantially higher.

Patients often don’t take medications as prescribed for a variety of reasons which have nothing to do with cost, including side effects and lack of understanding. Cost as a reason for nonadherence can be addressed in plan design.

Implications for employers:

-        Employers should consider affordability as they design their benefits.

-        Employers can put medications for some chronic diseases, like diabetes, on a preventive medicine list to bypass deductibles and/or provide without cost sharing.

-        Plan members who are concerned about drug cost can sometimes make prescriptions affordable by switching to a generic or using discounts or drug copay assistance

Thanks for reading.  You can find previous posts in the Employer Coverage archive

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