You Might Think Not Taking Your Medicine Is Harmless—But It’s Costing Us Billions

When was the last time you stopped taking a prescription early because you were feeling better? What about the time the doctor wrote you a prescription you didn’t think you needed, so you never filled it? Or maybe sometimes, in the middle of a hectic morning, you just forget to take your medicine. It’s a problem many of us are guilty of. I’ve stopped taking a round of prescribed eye drops when my infection cleared up. A friend recently decided not to fill a round of antibiotics for a urinary tract infection. The offenses vary in severity, but one thing is clear: We often think not taking our medicine is harmless. In reality, it’s costing us billions.

Between $100 billion and $290 billion annually, to be exact. Why so pricey? Because patients who don’t take their medicine oftentimes land in the hospital, adding extra strain to our health care system. One in 10 hospitalizations and 125,000 deaths each year occur for this very reason. It may seem mind-boggling that something as innocent as skipping a couple of pills could have such drastic effects, but consider the fact that more than half of the 3.8 billion prescriptions written in the United States every year are never taken (or taken incorrectly). And 30 percent are those prescriptions are never even filled. That is a lot of missed doses.

The reasons people don’t take their drugs vary: some are bothered by or concerned about the side effects; others don’t want to identify as “sick”—people don’t want to take medicine while they feel fine; they want to avoid dependency; they’re “old-fashioned”; they’d rather opt for a natural treatment. One of the most common reasons, however, is the high cost of medication. When cost is an issue, it’s easier not to fill prescriptions, to skip doses or cut pills in half, or to find alternative options altogether. But many fail to realize that without a doctor’s guidance, these “alternatives” can be extremely dangerous—and even more costly.

[quote position="full" is_quote="true"]The most common reason people do not take their medication is the cost.[/quote]

Allergy and immunology expert Dr. Mahboobeh Mahdavinia sees this all the time in her asthma patients. “The most common reason people do not take their medication is the cost. Copays have increased and insurance companies are not covering as well as they used to,” Dr. Mahdavinia says. “I think close to 30 percent of patients in the past year failed to fill up—and this has definitely increased due to insurance changes.”

She’s right; insurance companies are covering fewer medications than they used to, and drug prices are set to increase up to 12 percent in 2017 alone. The most commonly prescribed drugs are Vicodin, a painkiller; Synthroid, which treats hypothyroidism; Deltasone, which treats arthritis and certain cancers; Prinivil, which treats heart conditions, including hypertension and congestive heart failure; and Amoxil, which treats infections. The cost for a month of each of these is relatively low—the equivalent of a couple cups of coffee—$14, $12, $5, $7, and $9, respectively. But, about 20 percent of Americans are taking five or more prescriptions at a time. Even the cheapest meds add up quickly when there are multiple.

In cases of patients not being able to pay, Dr. Mahdavinia tries find cheaper alternatives, focuses on lifestyle modifications, and even calls insurance companies, but the reality is, patients end up in the emergency room “all the time” because they don’t take their medication. And, unfortunately, there’s no such thing as free medicine: The average emergency room visit is $2,168, and a three-day hospital stay quickly adds up to an average of $30,000.

If you think that a $30,000 hospital bill sounds unrealistic, consider this study, which weighed the cost of hospitalizations caused by patients not taking their medicine against what their prescriptions would have cost them instead. For patients with congestive heart failure, hypertension, diabetes, and dyslipidemia, the hospitalization costs per year ranged from $12,000 to $39,000. Compare that to the $3,780 per year that even the most expensive drug regime would have cost. No one likes paying for medication, but it beats winding up in the hospital with a bill that’s 10 times more expensive.

Free medicine isn’t exactly a possibility for the pharmaceutical industry right now, but it just might be the answer to both the question of individual cost and systematic cost for people who skip doses. For example, when Aetna gave medications to patients for free, 6 percent more took them as prescribed, and 11 percent fewer heart attacks and strokes occurred—compared to patients who paid for their medications. Another study published in Health Affairs found that more people followed their drug regime when cost was eliminated. What these studies suggest is that lowering or eliminating copayments might be the most cost-effective strategy for both patients and the health care system.

Until that happens, the one thing we can be sure of is that taking your medicine as prescribed saves money and lives. If not just for your health’s sake, the next time you think about skipping a dose, it’s worth bearing in mind the thousands it could cost you in medical bills down the line.