A new study demonstrates conclusively what many senior citizens who struggle to pay for their prescription drugs might suspect: Cutting back on your medications now because of cost means your health might suffer down the line.

The findings are based on an in-depth study over a three-year period of nearly 8,000 older adults who were regularly taking prescription medicines at the beginning of the study. By the end of the study, those who said they had had to cut back on their prescriptions because of cost were 76 percent more likely to have suffered a significant decline in their overall health, and 50 percent more likely to have had a heart attack, stroke or chest pain episode, than those who had not cut back.

These differences in health outcomes between the two groups held true even after factors such as age, race, income, education, smoking, alcohol use, obesity and co-existing health problems were taken into account.

In addition to the overall and heart-related differences, participants with depression who were over age 70 when the study began were more likely to have had a significant worsening of their depression by the end of the study if they had cut back on their medicines due to cost. But even the younger participants, who were in their 50s or early 60s when the study began, were more likely to suffer a health decline or a heart event if they had under-used their medications because of cost.

The findings, the first to show a real harm to health over time from restricting prescriptions due to cost, were made by a team from the University of Michigan and the VA Ann Arbor Healthcare System and based on nationally representative data from the U-M Institute for Social Research.

"Medications have been getting more and more effective at preventing or slowing the progression of health problems, but at the same time patients have increasingly been bearing the costs," says lead author Michele Heisler, M.D., M.P.A., a VA research scientist and lecturer at the U-M Medical School. "In our study about 10 percent of participants said they had cut back on their prescriptions due to cost, but we had a large enough group and a long enough follow-up time to see that they had significantly worse health outcomes than those who had not, even after three years."

Heisler hopes the findings will help inform policies on prescription coverage both before and during Americans' Medicare years, and shape the debate on whether short-term drug spending might lead to long-term savings by averting health problems.

Heisler and her co-authors also note that the findings show how important it is for doctors to ask their patients if they'll have any trouble paying for the drugs they are prescribed. In another paper published in February, she and her colleagues showed that 75 percent of patients who were having trouble paying for their drugs hadn't been asked by their doctors if they could pay for them.

And, she emphasizes, patients with concerns about costs shouldn't be shy about speaking up to their doctors. "Our results indicate you may be putting your health at risk by letting financial considerations limit your medications," she says. "There are national, state and local prescription assistance programs, generic drugs and other ways to cut costs, but you should explore every option before cutting back – and don't hesitate to enlist your doctor's help in reducing your medication expenses."

For more information:

The University of Michigan Geriatrics Center: Prescription Assistance Program
http://www.med.umich.edu/geriatrics/communityprograms/
prescription.htm