Many Americans feel they cannot afford the medications prescribed to them, and in recent years about 20 percent have asked their doctors for cheaper alternatives, according to a federal study.

New data from the National Center for Health Statistics, part of the Centers for Disease Control, show a significant number of Americans using different strategies to deal with prescriptions that they find difficult to afford. The center noted that about 60 percent of adult Americans report that they take prescription medications, and that approximately 70 percent of prescribed medications come with out-of-pockets costs, which average around $6 for generic drugs and around $30 for brand-name drugs.

The study looked at three common strategies that consumers use to deal with the cost of prescription drugs: asking their provider for a lower-cost drug; not taking the medication as prescribed; and using alternative therapies.

Asking for a lower-cost medication

About 20 percent of patients asked their physicians for lower-cost drugs in 2017, the center found. This has held steady in the past three years, and is down from 2013, when nearly 26 percent of patients asked about lower-cost medications. The study found that women (22 percent) were more likely than men (16 percent) to ask for lower-cost drugs. Not surprisingly, insurance plays a big role: 39.5 percent of uninsured adults asked about lower-cost drugs; only 18 percent of those on private insurance and 16 percent of those with Medicaid coverage did so.

According to Consumer Reports, there are several ways patients and providers can work together to reduce the cost of prescribed medications. Obviously switching to generics is one route, but providers and clinics may be able to suggest other ways to cut some of the costs of prescriptions.

Not taking medications as prescribed

The study also looked at the strategy of not taking medications as prescribed. The most common scenarios here are when patients don't take as much of the medication as prescribed or change the timing of when they take the medication, in order to make the medication last longer.

Again, women (13 percent) used this strategy slightly more than men (10 percent). Insurance status made a big difference: 33 percent of uninsured patients used this strategy, while only 13 percent of Medicaid and 8 percent of privately insured patients did not take medications as prescribed.

Health experts say this strategy can be dangerous for patients. “Not taking medications as prescribed can cause serious problems,” wrote Howard LeWine, MD, chief medical editor of Harvard Health Publishing, in a 2015 analysis. “It can lead to unnecessary complications related to a medical condition. It can lead to a bad outcome, like a heart attack or stroke. It can also increase medical costs if hospitalization or other medical interventions are needed.”

Using alternative therapies

Some patients forgo the medication route and try alternative therapies, the study found. The number of patients taking this approach has been relatively low: well under 10 percent in recent years, according to the center. Just over 5 percent of patients reported trying alternative therapies in the 2017 data. Women (7 percent) reported trying this strategy more than men (4 percent). Uninsured patients went with alternative therapies 14 percent of the time; Medicaid patients were at 6 percent; and 4 percent of those with private insurance used alternative therapies.

The study was designed to measure the use of these strategies, not their effectiveness, but the authors noted that there are risks to not taking medications as prescribed by providers: “Cost-saving strategies to reduce prescription drug costs may have implications for health status and have been associated with increased emergency room use and hospitalizations, compared with adults who follow recommended pharmacotherapy,” they wrote.

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Looking for a better way: 3 strategies Americans use to afford prescriptions

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