Cost-related medication underuse among chronically ill adults: the treatments people forgo, how often, and who is at risk

Am J Public Health. 2004 Oct;94(10):1782-7. doi: 10.2105/ajph.94.10.1782.


Objectives: We sought information about the cost-related underuse of medications-which medications are underused, by whom, and how often.

Methods: Chronically ill adults were asked to identify how often they underused prescription medication for 16 health conditions because of the cost.

Results: Eighteen percent of respondents cut back on medication use owing to cost in the previous year, and 14% used less medication at least monthly. Although rates of underuse varied substantially across treatments, prescription coverage and out-of-pocket costs were determinants of underuse across medication types.

Conclusions: Many chronically ill adults frequently cut back on medications owing to cost. Patients are selective about the treatments they forgo. Out-of-pocket costs and inadequate prescription coverage may lead to adherence problems for many important medication types.

Publication types

  • Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

  • Aged
  • Chronic Disease / drug therapy*
  • Chronic Disease / economics*
  • Cost of Illness
  • Drug Costs*
  • Drug Prescriptions / economics*
  • Drug Utilization Review
  • Female
  • Financing, Personal*
  • Health Services Research
  • Humans
  • Male
  • Middle Aged
  • Patient Compliance / statistics & numerical data
  • Socioeconomic Factors
  • United States