The Cost of Not Taking Your Medicine
"Approximately 50% of medications for chronic illness are not taken as prescribed," according to a New York Times article I read a few months ago. In the article, "The Cost of Not Taking Your Medicine," a health "epidemic" affecting "more people than any disease" is sweeping across the United States right now: nonadherence to prescribed medication.
What is "nonadherence" exactly?
Medication nonadherence basically means not taking your medicine (at all) or not taking it as prescribed by your physician(s) or not following physician's orders for treatment. According to a review in Annals of Internal Medicine, mentioned in the New York Times article,
“Studies have consistently shown that 20 percent to 30 percent of medication prescriptions are never filled. People who do take prescription medications — whether it’s for a simple infection or a life-threatening condition — typically take only about half the prescribed doses."
Wow, these are kind of shocking numbers; I never realized that nonadherence was so prevalent and such a problem. My personal medication-taking habits differ greatly, for the most part, from the non-adherent patients described in the article. I feel a bit embarrassed that I had no idea about this issue.
Here are some more shocking numbers if the first ones didn't get your attention. According to the Annals' review, this lack of adherence is estimated to cause approximately 125,000 deaths and at least 10 percent of hospitalizations, and to cost the American health care system between $100 billion and $289 billion a year.
Billions of dollars a year?! OK, yes, this is a huge problem. Why aren't people taking their medications? Don't they want to get better? There are no simple answers to these questions, of course. Several reasons can explain why people don't take their medications as prescribed or at all, including: cost, side effects, forgetfulness, emotional reasons, preference for "natural" remedies, lack of symptoms, confusing medication directions.
Nonadherence and RA
Cost is a big issue when it comes to nonadherence and RA, especially if patients are prescribed any of the insanely expensive biologic medications. Biologic drugs can cost around $4,000 a month (or more), and many people have trouble paying due to high insurance deductibles, copays, and coinsurance. Luckily, most if not all of the pharmaceutical companies have financial assistance programs for the biologic drugs--if you qualify. But I've heard from several people about how they can't afford their RA medication or office visits (and lab work, etc.) so they go without proper treatment.
Personally, I've always strictly adhered to taking my RA medication, all medication, the correct way and according to how it's prescribed since I was diagnosed. I often joke about being a self-diagnosed hypochrondriac, but I do take my health very seriously and often have a lot of anxiety about it. The intense pain and disability (and possible disfiguration) that comes with RA also scares me too much to not stay on top of the disease and my health care the best I can.
I am pro-treatment for RA
As a result of my pro-treatment attitude, I've fallen into a very deep, black hole of medical debt, accumulated from years of expensive drugs, office visits, blood work, and other RA costs. However, even though being in debt is incredibly stressful and demoralizing, I would much rather have my RA stable than being disabled by it because of lack of proper care.
Speaking of attitude, I think emotional reasons for not taking RA medication affect a lot of people who have the disease. Choking down several different pills each day gets to be a big burden. Seeing your pills piled up in your hand or lined up on the kitchen counter every morning is also a constant reminder that you're sick and that something is wrong with you. Nobody wants to be reminded of that, of course.
Whether it's cost, emotional reasons, forgetfulness, side effects, or anything else that makes people not take their RA medication as directed, nonadherence is happening everywhere and is causing patients and the healthcare system more harm in the long-run. The New York Times article offers some suggestions about how to help people get better at taking their medication:
- Use your smartphone to set reminders to take your medication doses,
- Try using a "buddy system" to help encourage yourself and a friend to stay on top of things,
- Put your prescription bottles in a convenient place that's easy for you to see and access each day.
Quiz: Which is NOT a common risk factor for osteoporosis?