Heart disease is the leading cause of death in the U.S., yet one in eight Americans who suffer from the condition can't afford to take the medication they need to stay alive, according to a new study from the American Heart Association.
To save money, many patients either skip doses, take a lower dose than what is prescribed or delay filling a medication, the study found.
"In recent years, insurance has been shifting the cost of health care to patients via higher deductibles, co-pays and co-insurance," said Dr. Khurram Nasir, one of the authors of the study, as well as a cardiologist at Houston Methodist hospital and a professor at the Yale School of Medicine. "In our practice, we can see that our patients are feeling the pinch."
Researchers used National Health Interview Survey data from 2013 through 2017 to determine what percentage of people with heart disease isn't following doctors' orders specifically because of medication costs.
For patients, deviating from a treatment regimen poses health risks, medical experts say. It also raises overall health care costs when someone's condition worsens and they require emergency room visits or hospitalization.
Inadequate health coverage
Roughly 2.2 million Americans reported not taking their pills as prescribed, the AHA found. Poor, uninsured patients were more likely to stray from a prescribed treatment plan than those who had insurance and earned more money.
By contrast, Medicare patients were two to three times more likely than privately insured patients to take their heart drugs. This suggests that manyhave inadequate coverage, according to Dr. Nasir.
"In the current for-profit environment, where insurers are reaping billions in profit at the expense of consumers, patients are becoming non-adherent to medication," he said.
Dr. Nasir said the AHA's findings point to a need to expand Medicare to cover treatment for more health conditions, including heart disease and cancer, positing that approach as a more politically realistic compromise to "" plans of the kind proposed by Senators Bernie Sanders and Elizabeth Warren.
Wealth affects health
Dr. Nasir also urged more doctors to speak with their patients about their finances. "Physicians need to speak up about alternatives rather than waiting for patients to. We need to actively screen patients for their inability to pay medical bills during our visits — that means coming up with good screening tools for financial toxicity."
Ultimately, the onus is on physicians, insurers, and the government to make sure patients aren't dissuaded from taking their medication because of its cost, he said.
"Patients are already suffering from morbidity and risk of death, at least we can play a role in reducing their financial stress so they don't have to choose between taking a pill and putting food on the table."