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Drug prices cause diabetics to forgo meds, food
By Alison McCook
NEW YORK (Reuters Health) - Nearly one in five older diabetics
say they can't afford necessary medications, and more than one in
four say they sacrifice food and other essentials to pay for prescription
drugs, new research reports.
Moreover, nearly 15 percent report skipping doses of certain medications
at least once per month because of the cost.
These rates of medication cut-backs due to cost are "disturbingly
high," study author Dr. John D. Piette told Reuters Health,
and could have serious consequences for diabetics' health.
Medications help keep diabetics' blood sugar in check, Piette explained;
without this control, they are at risk of a number of serious, often
irreversible complications, including blindness, kidney failure,
infection and subsequent amputation of toes and feet, and pain from
nerve damage, he noted.
People with diabetes often have other life-threatening conditions,
like high blood pressure and cholesterol, and skipping medications
for those conditions can be deadly, as well, Piette added.
Consequently, in many cases, doctors and patients need to work
together to create a prescription regimen that patients can afford,
said Piette, of the Veterans Affairs Ann Arbor Health Care System
in Michigan.
Prescription regimens should address "the patient's most serious
clinical problems without being so prohibitively expensive that
the patient is unable to stick with the treatment plan, or must
cut back on basic necessities in order to pay the cost of prescription
drugs," Piette said.
To determine the sacrifices many diabetic patients are making to
afford prescription drugs, Piette and his colleagues surveyed 812
people at least 50 years old who were taking prescription medications
for diabetes.
Nearly 30 percent of study participants said they were paying at
least $100 out-of-pocket each month on prescription drugs.
Around 20 percent of participants said they had skipped doses of
certain medications during the past year due to cost, and 15 percent
reported doing so at least once per month.
Women, younger patients, people taking at least seven drugs and
those with higher out-of-pocket costs were more likely than others
to report skipping medicines because of cost.
Nearly one third of people said they had cut back on basic needs
like food and heat, while around one in 10 also turned to credit
cards or borrowing money from family or friends to cover the cost
of drugs.
Despite the toll of high drug costs, more than one in three participants
said they had never discussed their difficulties paying for prescription
drugs with a doctor or nurse, the authors write in the journal Diabetes
Care.
Although many people skip drug doses because of cost, most don't,
Piette noted. Future research should examine which patients are
most likely to cope with the high cost of prescription drugs by
skipping medications and forgoing other essentials, and how that
can be avoided, he said.
"When patients do cut back on their medications, we need to
understand how they decide which ones to forego, and what impact
those choices are having for their current and future health,"
he added.
SOURCE: Diabetes Care, February 2004.
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