Economic Pressures Leading Many to Make Medical Sacrifices

Sept. 28, 2011— -- Although she survived lung cancer and has such difficulty breathing she can't walk more than 60 feet without stopping, Sandy Kintz of Westport, N.Y., can't afford to take all the medication doctors prescribe for her.

"I'm on two inhalers and I have to take those," Kintz said. "Some drugs I couldn't afford, so I gave them up."

In 2006, doctors diagnosed Kintz, now 58, with late-stage non-small cell lung cancer. The former nurse underwent radiation and chemotherapy and since she had no health insurance at the time, cashed out a retirement account to pay for her medical care. The cancer went into remission, but she still suffers from lingering effects of the chemotherapy as well as lung disease.

She now has Medicare and receives disability income, but since she is unable to work, she lives on limited means.

"The inhalers cost $35 each, and then there are all the co-pays for doctor visits, and I live an hour away from the doctor, so there are the back and forth costs. I just don't take all the meds, because I'd have to give up on something else."

Kintz is far from alone in making health care sacrifices. According to a nationwide survey of more than 2,000 people by Consumer Reports, the economy has led 48 percent of Americans taking a prescription medication to make cost-cutting medical sacrifices, such as skipping doctor visits, refusing tests or buying cheaper drugs from foreign countries.

Nearly 30 percent of this group skimps on medication by not filling prescriptions, skipping dosages, cutting pills in half or taking expired medications. A higher percentage of low-income individuals engage in these money-saving practices.

The poll also found about half of Americans regularly take a prescription medication, and on average, they take more than four different ones.

"We've been doing this survey on an annual basis for three years, and more people than ever are taking some sort of action to cut medical expenses, and some things are risky, such as putting off a doctor's visit, delaying a medical procedure or refusing medical tests," said Lisa Gill, Consumer Reports' prescription drug editor. "In that group of people, it's a big jump from last year when it was 39 percent."

The majority of the people surveyed also said their doctors do not help lessen the financial burden by prescribing generics or talking about drug costs.

"We know that doctors may not be able to find out the exact price of a drug because of different insurance plans, but doctors definitely know there are generics available," said Gill. "Even though they may not know the exact co-payments, it's a trigger for the doctor to ask patients about their ability to pay for this medication."

Doctors agree they need to better communicate with their patients about potential financial barriers to care, but say patient load and the current health insurance model make it difficult to manage multiple aspects of care.

"There's a movement in this economy for clinicians to understand the financial barrier before recommending drugs, devices or diagnostic tests," said Dr. A. Mark Fendrick, professor of medicine at the University of Michigan Medical School.