The Pharmaceutical Journal
Vol 270 No 7232 p69
18 January 2003

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Bigger co-payments lead to falls in compliance, new US survey finds

Compliance with prescribed medicines decreases as the amount that patients have to pay for them increases, a survey from the United States has found.

The survey of over 1,000 adults, carried out by Harris Interactive, found that as the proportion of the cost patients had to pay from their own pockets rose, they did four things: 18 per cent did not ask for prescriptions, 22 per cent did not have issued prescriptions dispensed, 15 per cent used lower doses to make their medicines last longer, and 18 per cent used the medicine less often than prescribed.

Among those with annual out-of-pocket costs of $500 (£315) or more, the number taking these actions more than doubled to 42, 44, 41 and 46 per cent, respectively. Patients who described themselves as being in either fair or poor health were around three times more likely to try one of these strategies than those in excellent or very good health.

In the 6 December 2002 issue of its Health Care News, Harris Interactive says that out-of-pocket costs for prescription drugs in the US have been rising rapidly because of the introduction of newer and more expensive drugs, changes to health insurance plans, greater drug use driven by direct-to-consumer advertising, and an increase in the use of tiered formularies with larger payments for higher tiers.

Harris Interactive says that increased non-compliance is likely to have a serious impact on people's health. Increasing co-payments may bring short-term cost savings, it says, but non-compliance could lead to more expensive treatment being needed in future.

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