High Co-Pays Keeping Chronically Ill From Their Meds

Many are waiting years after a diagnosis to fill a first prescription, study finds

By Amanda Gardner
HealthDay Reporter

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MONDAY, April 27 (HealthDay News) -- Rising co-pays may be keeping Americans with chronic illnesses from get the potentially lifesaving medications they need, a new study finds.

The problem may be symptomatic of rising health care costs in general and, according to Dr. Matthew D. Solomon, lead author of a study in the April 27 issue of the Archives of Internal Medicine, it's likely to get worse as the economy unravels.

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"As people's budgets are tightened, spending across all categories -- food, clothes, medicines -- will be trimmed," said Solomon, who is a medical resident at Stanford University School of Medicine and a consultant with the nonprofit research group the Rand Corporation.

"This study comes in the midst of a national discussion about how to control health care costs. A major focus is better management of care for those with chronic conditions," added Carol Pryor, policy director of The Access Project in Boston.

With rising prescription-drug costs, health plans have been passing more of their cost onto consumers, often in the form of higher co-pays.

But the new findings "suggest that increasing cost-sharing for this vulnerable group [of chronically ill patients] is counterproductive -- we need to make it easier for people with chronic illnesses to follow a treatment regimen to avoid greater costs for untreated disease later on," Pryor said.

Previous studies have shown that this practice has led to pared-down drug usage. One recent paper found that veterans' adherence to medication dropped more among veterans who had to make co-payments that increased in 2002, versus those who had no co-pays. Those making co-pays were also three times more likely to be without medication for more than three months.

The authors of this study looked specifically at why this phenomenon is occurring by delving into the records of more than 17,000 patients in 31 different health plans to track any delays between first diagnosis and when the patient started their medication.

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