High Co-Pays Keeping Chronically Ill From Their Meds

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All patients were newly diagnosed with hypertension, diabetes or high cholesterol between 1997 and 2002.

Previous studies have linked not taking or skimping on medicines to worse health outcomes. "If you do not treat these illnesses, you will end up with a higher rate of heart attack and stroke," Solomon said.

Five years post-diagnosis, 21.5 percent of patients with hypertension had still not initiated drug therapy, and neither had 36 percent of people with high cholesterol or 32.5 percent of those with diabetes.

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Crunching the numbers further, the team found that as co-pay amounts doubled, the percentage of patients who had started their medications dropped. For example, five years after their diagnosis, about 82 percent of people with hypertension had begun taking the drugs they needed to get their blood pressure under control, versus only about 66 percent of those whose co-pays were twice as much.

People who had never before taken prescription medicines were even less likely to fill their new prescriptions, the study found.

One strategy to ameliorate the problem could be to stratify co-pays depending on the specific drugs or severity of the condition. "Do we care if somebody has a high co-pay for Viagra? Maybe not as much as if they have a high co-pay for a diabetes medication," Solomon said.

Also, people who generally don't like taking medication tend to be extra-sensitive to co-payments, the study found. This group might respond well to a reduction in these payments, Solomon said.

Other experts felt that the consumer could themselves counteract, at least partially, the burden of rising co-pays.

"People should shop for drugs they way they shop for groceries," said John Goodman, founder and president of the National Center for Policy Analysis (NCPA), a free-market think tank in Dallas. Also, "some drugs can be split, so, by buying larger pills and splitting them, you can cut costs in half," he reasoned.

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