Older Americans Not Asking Physicians, Pharmacists for Help with Drug Costs

While a majority of Americans age 50 and older take 2 or more prescription drugs, results from a new poll suggest that this population may not be asking for help to cover out-of-pocket costs.

Data from the National Poll on Healthy Aging revealed that older Americans struggle to afford their prescriptions but may not consult with their physicians or pharmacists to find lower-costing options.

These results represent an opportunity for physicians and pharmacists to talk with patients about drug costs and concerns that may arise, according to the authors.

“We already know that cost can keep patients from taking the drugs they need to maintain health or prevent complications, but these new data suggest that many older adults aren’t talking to their doctors or pharmacists about cost and less-expensive alternatives as often as they could,” said researcher Preeti Malani, MD. “This represents an opportunity for patients, clinicians — as well as health systems, insurers and policymakers.”

Out-of-pocket costs can vary greatly depending on insurance coverage and the list price of the medication, making some treatments out of reach for certain patients. Rising drug prices can result in higher medication spending and a greater cost burden, especially on older Americans on a fixed income.

The poll included 2131 adults aged 50 to 80 years who responded to questions related to prescription drugs to determine how patients are affected before and after becoming eligible for Medicare.

Of all the patients included, 27% reported that their treatments represented a financial burden.

Additionally, 1 in 6 patients reported taking 6 or more drugs prescribed by 1 or more physicians. These patients were found to be more likely to report problems affording treatment, according to the study.

Of the patients who indicated that drug costs posed a burden, 49% had not discussed the issue with their physicians; however, 67% of respondents who talked with their physician about drug costs were prescribed a less expensive drug, and 37% received a similar recommendation from a pharmacist, according to the poll.

“Based on these findings, and other evidence, we encourage patients to speak up during their clinic visits, and when they’re at the pharmacy, and ask about ways to reduce the cost of their prescriptions,” Dr Malani said. “But equally, we see a need for health professionals to find ways to more routinely engage with patients about cost — especially through formal medication reviews such as the one that Medicare will cover.”

The investigators discovered that more than half of adults aged 50 to 64 years were taking 2 or more medications, with 14% taking 6 or more medications.

For older adults aged 65 to 80 years, 20% reported taking 6 or more medications and nearly 90% of these patients were taking 1 or more prescription drug, according to the poll. Also, 1 in 4 of the older adults said they saw 4 or more physicians in the past year.

Physicians, pharmacists, and other healthcare professionals can help navigate patients through options that may reduce out-of-pocket costs by lowering co-payments and recommending generics, according to the study.

During routine physician visits, providers typically do not have information about what a certain drug will cost based on insurance. This leaves the patient to bring up their concerns during the appointment or after a price is higher than expected. Patients may also be able to discuss cost options with pharmacists, who may have a better understanding, the authors wrote.

Additionally, patients with many prescriptions from multiple prescribers may have difficulty getting their out-of-pocket costs down, as providers may not want to revise drugs prescribed by others.

While long-term medication adherence can result in optimal patient outcomes, cost can be a factor when patients are not taking their treatments as prescribed. To save money, patients may cut back on doses or stop taking the drug without consulting their provider.

The authors encourage patients and providers to frequently engage in discussions related to drug costs until there is a policy created to facilitate the talk, according to the study.