CDC Data Shows Link Between High Costs and Prescription Nonadherence in Adults

According to the 2021 National Health Interview Survey (NHIS), out of the 57.9% of adults aged 18 to 64 years who took prescription drugs in 2021, approximately 8.2% (9.2 million adults) reported not taking their medications as prescribed due to cost concerns. This included strategies such as skipping doses, taking less medication than prescribed, or delaying prescription refills.

The data revealed variations in medication adherence based on demographic and socioeconomic factors, as well as disability and health status, health insurance coverage, and prescription drug coverage. 

Women were more likely than men to not adhere to medication regimens as prescribed. The percentage of adults not taking medication as prescribed decreased as family income increased. Individuals without health coverage, those in fair or poor health, and those with disabilities were among the most likely to face challenges in adhering to prescribed medications.

Although the average price per prescription remained stable between 2020 and 2021, the number of retail prescriptions increased. Consequently, out-of-pocket spending on prescription medications rose by 4.8%. 

Cost saving measures, such as skipping doses or delaying prescription refills, can have detrimental effects on health conditions. They may lead to the worsening of illnesses, potentially requiring more extensive and expensive treatments; therefore, these strategies have implications not only for individuals' health but also for the overall costs of health care, researchers said.

The data for this analysis was obtained from the 2021 NHIS, a comprehensive household survey representing the US civilian noninstitutionalized population. 

To determine medication nonadherence due to cost, the survey included questions on whether respondents had skipped medication doses, taken reduced doses, or delayed filling a prescription in the past year to save money. The disability status of individuals was determined based on their reported difficulties in functioning across various domains, including vision, hearing, mobility, communication, cognition, and self-care. Family income was assessed as a percentage of the federal poverty level, utilizing the US Census Bureau's poverty thresholds. Health insurance coverage was categorized into private coverage, Medicaid and other public coverage (including CHIP), other coverage, and uninsured. Prescription drug coverage was determined based on the type of coverage individuals had at the time of the interview, distinguishing between private and public coverage.

Understanding the factors contributing to medication nonadherence due to cost can help policymakers and health care professionals develop strategies to mitigate these challenges, the authors said. By addressing the financial barriers to medication access, it is possible to enhance medication adherence, improve health outcomes, and reduce the burden on the health care system.