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Reporting on health and quality of life in South LA

Some cope with high drug prices by buying foreign brands, skipping doses: report

More than 8 percent of adults skipped doses on drugs they were prescribed in 2011 in order to keep costs down, says a new federal report.
More than 8 percent of adults skipped doses on drugs they were prescribed in 2011 in order to keep costs down, says a new federal report. John Moore/Getty Images

About 13 percent of adults didn't take medication as prescribed in order to save money in 2011 – and being poor made people twice as likely as their wealthier counterparts to do so.

That's according to a new report from the National Center for Health Statistics (NCHS), which noted that Americans spent $45 billion in out-of-pocket costs – that is, costs that weren't covered by insurance or some other program – on retail prescription drugs that same year.

Louise McCarthy, the president and CEO of the Community Clinic Association of Los Angeles County, illustrated how easy it is to arrive at that number.

"The cost for AIDS drugs, if we were to just provide them with no subsidy or no program to help them be affordable, would be $26,000 per year, per person," she said. "That's the average cost of medication for someone who's living with HIV."

And it's "absolutely the difference between life and death," she added. That's why the NCHS' findings are so worrisome – drugs are prescribed for a reason, she said. But they're also pricey.

"There are a lot of folks with coverage and without that struggle with the cost of their medicine," she said. "And community clinics and health centers, one of the things that we look to do is to make sure the people get access to any type of program that can make drugs more affordable."

How people deal with high drug prices

When drugs aren't affordable, the NCHS data shows what can happen.

There's the 13 percent of adults younger than 65 in 2011 who didn't take their drugs as prescribed in order to save money. But there's also the 2.1 percent who bought prescription drugs from another country. And the more than 8 percent who skipped doses.

And the 8.5 percent who simply took less medicine, and the near 11 percent who delayed filling their prescription.

Those sorts of "strategies to reduce prescription drug costs," as the NCHS calls them, happen all the time among the community clinic patient population in L.A. County – and that certainly includes South Los Angeles.

"The thing that's scary when you find out about patients not taking their medication is that in the end, they're going to end up costing the system and themselves much more," said McCarthy.

Take diabetes, a condition which affects 12 percent of South L.A. adults. Not being able to afford the right types of medication or dosages is "no joke," she said.

"With insulin, that might not be life or death, [but] that might be whether or not you have your sight," she said.

L.A.'s community clinics usually offer the generic brands of drugs, as opposed to the brand-names, in order to keep costs down, said McCarthy. "The affordability issue can't be denied," she added.

One problem that clinics have to contend with happens after patients access care through hospitals or the emergency room, and then come to a clinic for a follow-up visit.

"They'll access care through the emergency room or hospitals and they'll be prescribed something that's outside the usual realm of primary care, and that's where we struggle," said McCarthy. "Those medications are often much more specialized and something that hospitals have more familiarity with than we do."

Still, she said people who try to get creative in how they reduce the costs associated with prescription drugs are essentially "taking their lives into their own hands."

The NCHS corroborates that. The report's authors wrote that people who don't take their medication as prescribed "have poorer health status and increased emergency room use, hospitalizations, and cardiovascular events."

Adults younger than 65 were more likely than adults older than 65 to not take medication as prescribed. The same was true of people who were uninsured, compared to those with some sort of insurance plan.

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