For more than 5 million Americans with heart failure, a critical step to better health is taking the medications they're prescribed. But many patients fail to do so, putting themselves at greater risk of hospitalization and even death. To date, studies have not fully answered why patients fall short when it comes to taking heart medicine. In a study appearing in the April issue of Mayo Clinic Proceedings, Mayo Clinic researchers found the drugs' cost is one of the biggest deterrents.
"We found patients weren't filling their prescriptions because of the expense," says Shannon Dunlay, M.D., Mayo Clinic cardiologist and lead author.
The study recruited patients from Olmsted County, Minn., and tracked their pharmacy records. Previous studies looked only at electronic prescription claims data, possibly missing drugs purchased with cash or not covered by insurance, Dr. Dunlay says. The 209 patients in the study, ages 60 to 86, were asked how often they missed doses or didn't take drugs at all, and why.
Researchers found that younger patients were slightly more likely to skip certain heart medications than older patients. Men were less likely than women to stick to certain drug regimens. Among patients who did a poor job following prescriptions, financial concern was the main reason: 46 percent reported that they had stopped taking statins or not filled a prescription because of cost, and 23 percent acknowledged skipping doses to save money.
Although 77 percent of patients in the study were eligible for Medicare, medication costs were still an important issue for some of them.
Dr. Dunlay emphasizes that heart failure patients worried about medication costs should tell their physicians. There often are lower-cost alternatives, she says.