Medical FYIs

Prescription Drug Coverage and Seniors

According to a recent national survey, four of 10 seniors did not take all the drugs prescribed to them by doctors in the past year, due to cost, side effects, perceived lack of effectiveness, or the belief that they did not need the medication. The survey of 17,685 Medicare beneficiaries was conducted by researchers at Tufts—New England Medical Center, Henry J. Kaiser Family Foundation, and The Commonwealth Fund, and led by Dana Gelb Safran of Tufts' Health Institute.

Survey results showed that many U.S. seniors are taking complex drug regimens prescribed by multiple physicians and obtained at different pharmacies, with some seniors getting drugs from Canada and Mexico. In addition, prescription drug coverage varies widely, with a large percentage of low-income seniors lacking any kind of coverage, according to "Prescription Drug Coverage and Seniors: Findings from a 2003 National Survey."

• Nationwide, 27 percent of all surveyed seniors and one-third of poor and near-poor seniors (101%–200% of the federal poverty level) lacked prescription drug coverage.

• Eighty-nine percent of the surveyed seniors reported taking at least one prescription medication, and nearly one-half of those reported that they used at least five prescription medicines.

• More than half of seniors (54%) reported having more than one prescribing physician, and 36 percent said they used more than one pharmacy.

• Nearly one-third of seniors reported spending at least $100 per month out-of-pocket on prescriptions. Five percent reported buying some medicines from Canada or Mexico. Three sub groups were especially prone to high out-of-pocket costs: seniors without prescription coverage, lowincome seniors, and those with three or more chronic conditions (referred to as the complex chronically ill).

• Although seniors without coverage took significantly fewer medicines than those who had coverage, they were twice as likely to spend $100 or more per month out-of-pocket and reported higher rates of costrelated nonadherence than other groups. They were also more likely to purchase medications from Canada and Mexico.

• More than one-quarter of the surveyed seniors (26%) reported forgoing prescription medications in the past year because of costs, and 12 percent said they spent less on basic needs in order to compensate for high medication costs.

• One-quarter of seniors reported some form of experience related nonadherence, and percentages were even higher among those lacking coverage (27%), low-income seniors (28%), and the complex chronically ill (34%).

Source: Tufts—New England Medical Center, Henry J. Kaiser Family Foundation, and The Commonwealth Fund, April 2005.

http://www.cmwf.org/publications/publications_show.htm?doc_id=273944