New Survey: More Than Half of Americans Do Not Take Prescription Medicines as Instructed, Pointing to Growing Public Health Problem

A new survey finds that 54 percent of Americans say they do not consistently take prescriptions as instructed even though 87 percent believe prescription medicines are important to their health – pointing to a growing public health problem.

The survey examining prescription adherence was released today by Prescription Solutions, a leading pharmacy benefit management organization and a UnitedHealth Group (NYSE:UNH) company, and the National Council on Patient Information and Education (NCPIE).

Poor adherence to medications – the extent to which people take their medications as prescribed by their doctor – can have adverse effects on people’s health. It diminishes the ability to treat chronic conditions like diabetes, heart disease, cancer, asthma and many other diseases; and it can result in suffering, an increase in hospitalizations and even death.

Non-adherence with prescription medications also is a key source of unnecessary cost in the U.S. health care system. According to a recent New England Healthcare Institute (NEHI) study, otherwise avoidable medical spending resulting directly from non-adherence accounts for up to $290 billion per year, or 13 percent of total health care expenditures.

The Prescription Solutions/NCPIE survey found that nearly 60 percent of respondents believe that when people take their prescription medications as instructed, it will lead to better health and it can help lower costs to the health system.

"The hidden health, financial and productivity costs of people not following their medication regimens as instructed are profound, making prescription non-adherence a national health problem,” said Jacqueline Kosecoff, chief executive officer of Prescription Solutions. "The survey clearly shows that people need and want more information, guidance and help understanding and using prescription medicines.”

Feeling Better and Side-Effect Concerns Are Top Reasons for Non-Adherence

Of those surveyed, 37 percent said they did not finish taking all the prescription medicine as instructed, and 31 percent said they skipped doses. Twenty-three percent said they did not refill their prescriptions as instructed.

When asked why they did not follow their doctors’ instructions, 59 percent said that they started to feel better and didn’t think it was necessary to keep taking the prescription medicine. Four in ten (37 percent) said they were concerned about side effects, while 25 percent said that they weren’t feeling any better so they didn’t think it was necessary to keep taking the prescription medicine. Nearly a quarter (24 percent) said they stopped taking the medicine because it was too expensive.

"Poor medicine adherence – dubbed by NCPIE over two decades ago as ‘America’s other drug problem,’ – appears to be as pervasive and costly in terms of health and economic consequences today as in years past,” said Ray Bullman, executive vice president of NCPIE. "These survey findings underscore the challenge of non-adherence and the need for frequent and ongoing communication between consumers and their health care providers about medicines so that consumers recognize the value of medicines properly used and can derive the maximum benefit – and the minimum risk – from their prescription medications.”

Data Suggest Refill Reminders, Regular Check-Ins, Easier-to-Read Instructions Would Aid Adherence

When asked what would help them take their medications as instructed, 39 percent cited refill reminders. Twenty-five percent of respondents said they would do better at taking their prescription medicines as instructed if someone were to follow up with them or encourage them along the way; this could include a loved one, caregiver or health care provider, for example. More than a third (34 percent) said that they would adhere better if they were provided easier-to-understand instructions about how to take their prescription medicines. Nearly half said lower cost for prescription medicines (49 percent) and fewer side effects (48 percent) would help them better take their medications as instructed.

Most Americans Are Reading Prescription Medicine Instructions; Men and Women Differ

Among additional findings of the survey, when it comes to reading the instructions that come with their medicines, 73 percent said they read both the label and the information on the medicine insert. Women are more apt to read both the label and the printed information on the insert (82 percent) compared with men (63 percent). Only 2 percent say they don’t read any of the materials.

In addition, when they’ve experienced a prescription medicine side effect, women are far more apt to talk to their doctor or pharmacist (72 percent) versus men (57 percent), further illustrating gender differences when it comes to problem solving through information seeking.

The Road to Better Adherence

"As our aging population grows, more people are taking multiple medications, and we have to employ a variety of pro-active and responsive strategies to help people improve their adherence,” said Joseph Addiego, M.D., senior vice president and chief medical officer for Prescription Solutions. "Prescription Solutions is doing its part to serve the needs of our customers and the entire health care system by offering an array of clinical programs that support people in adhering to their prescriptions so they can improve their health – ultimately leading to lower costs for everyone.”

Prescription Solutions and NCPIE both offer tips for consumers when it comes to taking prescription medications, including:

• Ask your doctor or pharmacist about instructions for use and possible side effects whenever a new medication is prescribed.
• Share information with your health practitioners about all the other medications, vitamins and herbal supplements you are taking to avoid negative drug/drug interactions and reduce the potential for side effects.
• Keep a current list of all medications you are taking, both prescription and over-the-counter and share this with your doctor at each visit.
• Read carefully the information that comes with your medication and save it for future reference.
• Call your doctor, pharmacist or pharmacy benefits manager if you are experiencing side effects from your medication.
• Consider cost-saving and convenient options like mail order and use generic alternatives where appropriate.

Prescription Solutions, a NCPIE member organization, was recently appointed to a seat on NCPIE’s board of directors.

Survey Methodology

The national telephone poll was conducted October 22-25, 2009 by Opinion Research Corp. on behalf of Prescription Solutions and NCPIE. The national probability sample included 1,000 adults (500 men and 500 women), 18 years of age and older, and living in private households in the continental United States. The margin of error was +/- 3 percentage points at a 95 percent confidence level.

About the National Council on Patient Information and Education

Organized in 1982, The National Council on Patient Information (NCPIE) is a non-profit coalition of over 100 organizations committed to stimulating and improving communication between consumers and health care professionals about the safe and appropriate use of medicines. In addition to sponsoring "Talk About Prescriptions" Month (www.talkaboutrx.org), NCPIE hosts the "Be MedWise" campaign promoting wise use of over-the-counter medicines (www.bemedwise.org) and the "Medication Use Safety Training for Seniors” Program (www.mustforseniors.org). In August 2007, NCPIE released "Enhancing Prescription Medicine Adherence: A National Action Plan,” proffering 10 recommendations for stakeholder action to advance medication adherence. To review the recommendations, see: http://talkaboutrx.org/documents/enhancing_prescription_medicine_adherence.pdf

About Prescription Solutions

Prescription Solutions is an innovative pharmacy benefit management company managing the prescription drug benefit of commercial, Medicare and other governmental health plans, as well as those of employers and unions. A UnitedHealth Group company, Prescription Solutions serves members through a national network of 64,000 community pharmacies and state-of-the-art mail service pharmacies in Carlsbad, California, and Overland Park, Kansas, which have both earned the prestigious Verified Internet Pharmacy Practice Sites™ (VIPPS®) accreditation by the National Association of Boards of Pharmacy® (NABP®). The company was recently named by WilsonRx® as the No. 1 National Top-Tier PBM, and No. 1 National Mail Order Pharmacy for customer satisfaction two years in a row. Prescription Solutions also won two Silver Awards for URAC’s Best Practices for Consumer Empowerment and Protection Awards – Geriatric RxMonitor program (2008) and the Drug Interaction Alert Program (2009). Additional information can be found at www.prescriptionsolutions.com.

Prescription Solutions Clinical Programs Target Better Adherence and Health Outcomes; Contain Costs

Prescription Solutions offers a comprehensive suite of clinical programs that are designed to help people follow their prescription medication treatments and improve the quality and safety of care. These programs aim to improve health outcomes by ensuring appropriate use of medications, and reducing the risk of adverse events, including drug/drug interactions and avoidable side effects. Prescription Solutions helps improve adherence and patient/doctor communication by providing refill reminders and notifications as well as education to both patients and doctors. These programs also help reduce overall healthcare expenditures by reducing costly hospitalizations due to adverse drug reactions, and preventing, delaying or minimizing the effect of additional diseases.

About UnitedHealth Group

UnitedHealth Group (NYSE:UNH) is a diversified health and well-being company dedicated to making health care work better. Headquartered in Minneapolis, Minn., UnitedHealth Group offers a broad spectrum of products and services through six operating businesses: UnitedHealthcare, Ovations, AmeriChoice, OptumHealth, Ingenix, and Prescription Solutions. Through its family of businesses, UnitedHealth Group serves more than 70 million individuals nationwide.

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