18% of patients younger than 65 say they can't afford to take meds as prescribed.
This article first appeared on Wednesday, August 21, 2019 in MedPage Today.
By Kristen Monaco, Staff Writer, MedPage Today.
Confirming widespread anecdotal reports, recent federal survey data indicate that high costs of diabetes drugs drive many patients to cut corners in their treatment regimens.
Findings from the 2017-2018 National Health Interview Survey show that nearly one-quarter of adults with type 1 or type 2 diabetes (including those on Medicare) asked his or her doctor for a lower-priced diabetes medication, according to a data brief from the CDC's National Center for Health Statistics (NCHS) released early Wednesday.
Even more alarming, 13% of adults of all ages diagnosed with diabetes reported they didn't take their medications as prescribed in order to cut costs, reported NCHS researchers Robin Cohen, PhD, and Amy Cha, PhD, MPH.
Specific tactics included skipping doses, splitting pills, and delaying prescription refills. Women were more likely than men (14.9% vs 11.6% of all individuals with diabetes) to report modifying their drug regimens because of cost.
Patients 65 and older, presumably on Medicare, were less likely to report non-adherence for cost reasons than younger adults (7.2% vs 17.9%). Just over one-third of those ages 18-64 without insurance said they couldn't afford to take medications as prescribed.
"In 2018, medications to treat diabetes ranked sixth out of the top 20 therapeutic classes of dispensed prescriptions, accounting for 214 million prescriptions," Cohen and Cha explained. In 2017, "the annual per capita expense for outpatient medication for those with diagnosed diabetes was almost $5,000."
"Recently, there has been a shift towards lower-cost options as the first line of therapy for diabetes management," they wrote. "However, the burden associated with high prescription drug costs remains a public health concern for adults with diagnosed diabetes."
Asking for cheaper medications was most common among uninsured patients, 43% of whom said they had inquired with their provider. But it was not infrequent among those with private insurance or Medicaid (26% and 19%, respectively).
In the Medicare population, so-called dual eligibles -- those on Medicaid as well -- appeared to have the least trouble with drug costs. Only 13% of dual eligibles asked physicians for cheaper drugs, versus 23% or more of those with other insurance types. Not taking medications as prescribed was reported by 6% of dual eligibles and those with strictly private insurance, versus 9% for those using Medicare Advantage or standard Medicare.
“The burden associated with high prescription drug costs remains a public health concern for adults with diagnosed diabetes.”
NCHS researchers
KEY TAKEAWAYS
13% of adults of all ages diagnosed with diabetes reported they didn't take their medications as prescribed in order to cut costs.
Patients 65 and older, presumably on Medicare, were less likely to report non-adherence for cost reasons than younger adults (7.2% vs 17.9%).
Just over one-third of those ages 18-64 without insurance said they couldn't afford to take medications as prescribed.