A study of a large, nationally representative sample of older Americans, to be published Dec. 4 in the Journal of General Internal Medicine, has found that 43 percent of those people without prescription drug coverage who are of minority ethnicity, have annual incomes of less than $10,000 and have out-of-pocket prescription drug costs of more than $100 per month reported restricting their use of prescribed medicines.
The study was conducted by researchers from the University of California, San Francisco, Department of Medicine, who collected information from a random sample of almost 5,000 Americans, 70 or older, with and without drug coverage, who regularly used prescription medicines. Even one of three risk factors – ethnicity, income and out-of-pocket drug costs of more than $100 a month – made it significantly more likely that people without prescription drug coverage would be forced to restrict their use of medications due to cost.
In the study, 20.9 percent of minority subjects, 15.6 percent of those with annual incomes under $10,000 and 13.4 percent of those with out-of-pocket prescription drug costs of more than $100 per month experienced medication restriction due to cost. Looked at from a different perspective, low-income study participants lacking prescription drug insurance were about 15 times more likely to limit their use of prescription drugs than low-income participants with full coverage.
Thus, in the absence of a prescription drug benefit, some of the country’s most vulnerable seniors are most likely to go without the medicines they may need to maintain their health. The study s authors note that previous studies have shown that “policies designed to limit medication use may have serious consequences for patients health, resulting in increased emergency department visits, nursing home admissions, [and] use of emergency mental health services.”
“These findings bring to the fore the idea that when you judge societies by how they treat their most vulnerable members, the United States ranks very low,” said Dr. Sidney M. Wolfe, director of Public Citizen s Health Research Group. “Our country fails to provide health insurance for about one-seventh of our population and fails to provide prescription drug coverage for millions of Medicare-covered older Americans who cannot afford to purchase drug coverage on their own.”
The results of the study are consistent with a Nov. 20 Harris Poll of a random sample of 1,010 adult Americans that found 39 percent of people with annual incomes of less than $15,000 a year had not filled a prescription for medicine in the previous 12 months.
Dr. Michael Steinman, the lead author of the study, works in the Department of Medicine, San Francisco Veterans Affairs Medical Center and at the University of California, San Francisco.