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.

Happy Holidays: Generic Lipitor Hits Pharmacies This Month

After a five-year reign as the #1 selling drug on the market, mighty Lipitor (aka atorvastatin) will come off patent on November 30th, 2011. Lipitor had more than $10 billion dollars in sales last year and has been prescribed to more than 17 million patients in the United States, alone.

In time for the Holiday Season, all those using the lipid-lowering blockbuster will be able to get their prescriptions filled for $30-$50/month shortly after Thanksgiving, as opposed to the nearly $200/month that they had payed on Halloween.

Despite several other statins already available in generic form (e.g. simvastatin, lovatstatin, etc), generic Lipitor, atorvastatin, will be the most potent to join the crew.

You can watch Dr. Howard Weintraub from NYU discuss it here.

Apps for Your Health

We have noticed in the office that an increasing number of patients have made the switch from standard mobile phones to "smart" phones - as have most doctors.

Besides functioning as phones, iPods, cameras, email receptacles and GPS systems, these devices and the apps designed for them, have also become an asset to both patients and their physicians.

If not only as a great place to keep your medication list, patients can also download as assortment of apps to

• Record and track blood pressure,
• Monitor your blood sugar trends,
• Count calories and break down food labels
• Take your pulse!

We have highlighted below just a few of the hundreds that are out there, but there are such a diverse array of helpful apps out there that we leave it to you to give us some other good ones!

iTriage - What they say: Created by two ER docs, iTriage helps you answer the questions: “What medical condition could I have?” and “Where should I go for treatment?” It also lets you save, easily access, and share the healthcare information most important to you. iTriage has been downloaded millions of times in over 80 countries and consistently receives a 4.5 (out of 5).

Glucose Buddy - Using Glucose Buddy, people with diabetes can manually enter their glucose numbers, carbohydrate consumption, insulin dosages and activities. Once the data has been entered, users are able to see trends and adjust their diets, meds and even activity, to better control their blood sugar.

Fooducate - Just pick up a product from the shelf, scan it, and let Fooducate do the rest. Scan and choose healthy groceries. Over 200,000 unique UPCs! As featured in USAToday, NYTimes, WSJ, Lifehacker, Gizmodo and on ABC, FOX, NBC and more...

BPMontior - The BPMonitor keeps track of your important health stats, right on your iPhone or iPod touch. It is one of the best health tracking apps, with features hard to find anywhere else. These include:
1. Ease-to-use interface to record your blood pressure, weight and heart rate
2. Support tracking for multiple people; one program for your entire family
3. Graphical charts for visual trend and warning
4. Stats table with average values for the past weeks
These are the ones we like but there are literally hundreds more out there for every health-related topic from assessing visual acuity to interpreting x-rays. The Medical category in the iTunes App store is a wonderful resource and we hope that you can point us to some additional great finds.