Unfilled Prescriptions

A study done by the Journal of General Internal Medicine shows that a significant number of prescriptions go unfilled. In this study, researchers found that among more than 75,000 Massachusetts patients given drug prescriptions over one year, 22 percent of the prescriptions were never filled. The rate was even higher -- 28 percent -- when the researchers looked only at first-time prescriptions.

Letting prescriptions go unfilled is called "non-adherence." Such "non-adherence," the study found, was common even among patients prescribed drugs for chronic conditions that can have serious health consequences.

The big question is why?  Exactly why many patients did not fill their prescriptions is unclear, but several reasons are possible.

1. The patient does not know why they are taking the medication
2. The patient's condition does not cause any symptoms
3. The patient cannot afford the medication(s)
4. The patient has concern about side effects
5. The patient doesn't want to take any medications

When health problems cause few or no symptoms -- as with high blood pressure or high cholesterol -- people may not see the need for a medication. Although there are many diagnoses that have no symptomotology, your disease is causing damage. When symptoms do occur, it will be more difficult to control and treat.

"If they do not fully understand the reason that they are being prescribed the medication, they may be less likely to take it," lead researcher Dr. Michael A. Fischer, of Brigham and Women's Hospital in Boston, told Reuters Health.  If you don't know why you are taking a medication, ask your doctor. It is our job to educate you about your diagnosis and advise you regarding all treatment options.

Cost could also be an issue, Fischer added -- particularly when people are unsure of why a drug is being prescribed.   All of the patients in the study had health insurance. But even with coverage, people may have high co-payments for medications or may be prescribed a drug not covered by their plan, Fischer and his colleagues note.

No matter what the reason, patients should not hesitate to talk with their physicians regarding their concerns. We especially need to know if you encounter side effects.

What's really scary about this study, though, is that these numbers reflect the behavior of people with health insurance (Massachusetts has a 97 percent insured rate). The numbers are undoubtedly higher among the uninsured.

Check out Trisha Torrey's blog as she takes the patients perspective. She gives the patient's responsibilty regarding prescriptions.

The Number of Uninsured Adults Contiues to Rise

Over the last 10 years, the number of uninsured adults in the U.S.--those ages 18 to 64--has steadily increased, and according to 2009 data from the Centers for Disease Control and Prevention, now sits at just over 21 percent. Overall, the number of uninsured people in the U.S. is now 46.3 million--roughly 15 percent of the nation's total population . Children under 18 and seniors 65 and older are more likely to be covered because they are more likely to qualify for government insurance programs, such as Medicaid and Medicare.  Regionally, the Southern and Western portions of the U.S. had the highest percentage of uninsured. Texas had the highest rate of uninsured people at 24.6 percent. At the other end of the spectrum, Massachusetts had the most citizens covered, with only 3.7 percent lacking insurance.(FierceHealthcare)

This is most likely is a symptom of job losses and the inability to afford health insurance as well as lower number of employers offering health insurance. To make things worse, Eighteen governors throughout the nation have ultimately decided against creating temporary high-risk insurance pools for those who are uninsured due to pre-existing conditions. The new health reform law allocates a total $5 billion to the states for the creation of such plans, which would run through Jan. 1, 2014. According to the Washington Post, the states that opted not to administer the risk pools include Alabama, Delaware, Florida, Georgia, Hawaii, Idaho, Indiana, Louisiana, Minnesota, Mississippi, Nebraska, Nevada, North Dakota, South Carolina, Tennessee, Texas, Virginia and Wyoming. (FierceHealthcare)

Texas, which has the highest rate of uninsured in the nation at 25 percent, is one of 35 states that already operates its own high-risk pool. The good news is that twenty-nine states as well as Washington, D.C., said they would participate in the plan.