The Recession Means Fewer Prescriptions Are Filled
8 CommentsBy Ed Silverman // March 18th, 2010 // 6:18 am
Somehow, this isn’t surprising. A new survey finds that patients with commercial health coverage are abandoning prescriptions like never before. Last year, the rate at which scrips were submitted to a pharmacy but never picked up was 6.3 percent, a 24 percent increase over 2008. And the rate for new scrips for brand-name meds hit 8.6 percent in 2009, up 23 percent from the year before, and up an eye-popping 68 percent from 2006. This occurred even as co-pays rose only $5 from 2008 to 2009.
Meanwhile, 66 percent of scrips filled last year were for generics, compared with 60 percent in 2008 and 50 percent in 2005. One reason cited for the increase is the growing number of low-cost generic programs promoted by such retailers as Wal-Mart. All totalled, there were 2.6 billion scrips filled for generics last year and 1.3 billion for brand-name meds, amounting to a 2.7 percent increase in the total number of scrips last year, according to Wolters Kluwer, which conducted the survey.
The states with the highest overall new abandonment rates for brand-name meds include Delaware, Florida and North Carolina, all which were above 10 percent.
Here’s another interesting revelation: Denials for new scrips for brand-name meds - these are scrips rejected by health plans - fell 1.4 percent last year from 2008, but rose 22.5 percent from 2006. Taken together, abandonment and denials meant that 14.4 percent of all new scrips covered by commercial plans went unfilled last year, up 5.5 percent from 2008. And the states with the highest denial rates for new brand-name med scrips were California, Delaware, Florida, Hawaii, Illinois, Maine, and Montana.
Photo: Maragaret Bourke-White
pharmavet
A bigger problem than abandonment is persistence, i.e. those patients who fill a prescription once and then don’t refill. This is such for “asymptomatic” conditions like hypertension or hyperlipidemia. Efforts should be made to educate these patients on refilling their script as well as for patients who are non-compliant. Technology exists for electronic detection of non-compliance in clinical trials, but has not been adopted for clinical use, due to expense and probably the “Big Brother” factor.
JaT
How about we start calling non-compliance a decision to discontinue.
Incidentally, I have several scripts I neither refilled or finished- of course they are mostly those that landed me in the emergency room. I suppose the technology doesn’t make that determination.
JaT
I just re-read your comment, pharmavet. In educating patients to refill- what would that include exactly? When the bottle is empty- drive 2 blocks, take a left and go 3 miles, make sure you are in the left hand lane…
lol
Former Pharma Marketing Director
Pharmavet,
To be really fair, you need to educate the patient on how to get safely off of the drugs by changing lifestyles. For example many cases of hypertension can be brought under control by significantly reducing carbohydrates, or going low fat
http://www.nhlbi.nih.gov/health/public/heart/hbp/dash/new_dash.pdf
http://hyper.ahajournals.org/cgi/content/full/48/4/555
elmore
There are also a lot of people–particularly the elderly–on multiple drugs from multiple doctors often unnecessary, and when a single doc finally reviews the whole lot, many are discontinued.
elmore
that should have read “that are often unnecessary”
Barry
Compliance has always been an issue. This trend toward “abandoning” prescriptions is new and is based on cost. The combination of insurance refusal, higher copays and the un-insured is pricing more and more people out of the market.
Pharmaceutical sales were down almost 10% in the U.S. last year and these are contributing factors.
The system is broken, agree or disagree with the health care plan, only some serious reform can help this particular problem.
pharmavet
Therapeutic substitution should be the law of the land, allowing all pharmacists to substitute a generic for a branded drug at the point of sale. For example, simvastatin should be substitutable with Lipitor if the equivalent doses are known (which pharmacists should know since the data are published). If an MD writes “DAW” or “medically necessary”, the patient’s insurance co. MD should have the right to switch to generic, except in the rare case of a Narrow Therapeutic Index drug. If patients knew that their Rx could be therapeutically substituted with a generic they might be less tempted to abandon.
I’m all for lifestyle changes re. hypertension, diabetes, etc., but I just returned from a routine shopping trip where I saw again the huge epidemic of not only obesity, but morbid obesity in this country. I daresay that lifestyle changes will not work for many of these people. It’s not a coincidence that every other person that I saw walking into Dunkin Donuts this morning probably had an obesity-related problem.