Medication Compliance: Not A Money Issue?

It's no secret that adherence to medications is not great in America - or the rest of the world, for that matter. But you would think that if the medications were shown in numerous studies to actually save lives people would take them, right? And, if these patients had just had a heart attack then you would think that they would really take them, right? And if you offered these life-saving prescription medications to these heart attack patients for FREE then they would absolutely positively take them, right?

Wrong.

In fact, barely half of the patients who received prescriptions for standard, post-heart attack medications, free of cost, were filling them after one year. The other group, the ones who had to pay about $50 per month (the average copay) fared only slightly worse. 

Dr. Niteesh Choudhry of Brigham and Women's presented his study's findings Monday at an American Heart Association conference in Florida. They also were published online by The New England Journal of Medicine.

The study did not examine why people didn't take their medications, but was funded by Aetna (yes, that Aetna) in an effort to see if providing free medications would impart clinical benefit to their patients, and decrease long term costs as a potential aide effect.  But it appears money is not the major issue limiting medical compliance in this country.

As a physician, and a patient, I can attest to the fact that compliance with doctors' instructions is affected by so many things, money often playing a minor role.

Why is it so hard to take the medications doctors precribe? Is it because it makes us actually feel the opposite of healthy to take a medication? Is it that we're too busy? Too forgetful? Maybe it's because we can't actually feel the positive effects that it has on our bodies - there's no tangible reward like there are with dangerous drugs that we can't stop people from taking, e.g. weight loss pills and anabolic steroids.

Perhaps doctors have to do a better job explaining what it is that patients are ingesting and why these medications will help them down the line - even if they can't feel it.

Instead of subsidizing co-pays, perhaps insurance companies could spend that money on patient education or programs that reward compliance, encourage physical activity and emphasize healthy milestones.

Are you compliant with your medications? If not, why? Tell us what makes it so hard to follow instructions that should ostensibly improve your health.