Things can be pretty tight financially
for many elderly patients, and scrimping and saving may
be a life long habit that's hard to break. But new research,
published in the July issue of Medical Care, has
confirmed that those who tighten their purse strings when
it comes to prescription medications are paying a heavy
price in terms of their health.
A team from the University of Michigan
followed nearly 8,000 older adults who were on regular
prescription meds. After three years, those who had
cut back on their drugs because of cost were 76% more
likely to suffer a significant decline in their overall
health, and had 50% more risk of heart attacks, strokes
or episodes of angina. Not exactly surprising? True,
but it's the first time the negative health impact of
cutting back on meds for economic reasons has been measured.
"Other studies have suggested that
this effect might exist, but only by looking at a snapshot
of a population at a moment in time," says author John
Piette, PhD. "It's not possible to randomize people
to cut back on their necessary medications, so this
is the next best thing."
Cardiovascular disease and depression
were the conditions most likely to deteriorate in patients
who skimped on medicines. In this group, 8.2% had suffered
a non-fatal heart attack or stroke by the end of the
study, compared with 5.3% of those who hadn't cut back.
Among older patients with depression, those who had
difficulty paying for drugs were 16% more likely than
others to deteriorate by at least one point on a standard
diagnostic scale.
Changes to US Medicare will see
some prescription drugs covered for the elderly, but
lead author Dr Michele Heisler noted that in this study,
it was patients in their 50s -- too young for Medicare
drug coverage -- who were most likely to reduce medication
due to cost concerns. "A lot of critics are saying it's
too expensive to provide or improve drug coverage, but
studies like this show that the downstream costs from
adverse health outcomes later may be more expensive
than the upstream costs now," she said. "It may be pay
now, or pay more later."
Surprisingly, medication costs
actually consume more of the healthcare bill in Canada
(16.2%) than in the US (12.4%) -- due more to increased
consumption than rising prices. At the same time, the
proportion paid by the public purse is growing. But
it remains to be seen if our government will react to
rising costs in the same way as America's seniors have,
with similarly unfortunate results.
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