Alzheimer's Patients Can't Afford to Take Their Medication Correctly Because of Out-of-Pocket Insurance Costs, Study Suggests

Out-of-pocket costs for drugs mean patients with conditions including Alzheimer's disease aren't taking their medication correctly, a study suggests.

With every $50 increase in out-of-pocket costs patients faced for a 30-day supply, there appeared to be a drop of between 5 to 10 percent in them taking medications as advised, the co-author of the study Brian C. Callaghan, from the University of Michigan, told Newsweek.

The authors of the paper, published in the journal Neurology, looked at data on private insurance claims made between 2001 to 2016. They noted the medicines that were similarly effective and tolerable for patients, but that cost different amounts. The researchers then estimated whether the patients were taking the recommended amount of medication by looking at the number of days they had a supply for in the first six months the drug was prescribed.

They examined data on three neurologic diseases: dementia—of which Alzheimer's which is the most common form—Parkinson's, and peripheral neuropathy, which affects nerves which carry messages to and from the brain, spine and the rest of the body. The data included 19,820 people with dementia; 3,130 people with Parkinson's disease; and 52,249 neuropathy patients.

When out-of-pocket costs increased by $50, patients with Alzheimer's and peripheral neuropathy were less likely to adhere to their medications, at 12 percent and 9 percent, respectively. Black, Asian, and Latino people were also less likely to have the correct medications compared with white patients when faced with the same costs, the study suggested.

In a statement, Callaghan said that if people are not following their prescriptions correctly, "they are less likely to benefit from the drug and see improvements in their condition, possibly leading to complications and higher costs later."

"These results are concerning, especially as we've seen the cost of prescription drugs continue to rise and an increasing amount of the cost being shifted to patients through out-of-pocket costs."

Callaghan said it is "critically important" for changes in policy to help ensure ethnic minorities are sticking to their drug schedules.

James C. Stevens, president of the American Academy of Neurology, which publishes Neurology, commented in a statement: "Out-of-pocket costs have risen to the point where systematic changes are needed."

Callaghan told Newsweek: "The best way to address the problem of out-of-pocket costs is with large scale healthcare policy change. Limiting the costs of medications would be a great start and also limiting the cost sharing with patients is another. In the meantime, our hope is that this study spurs patients and physicians to discuss out-of-pocket costs more so that physicians can help navigate patients to get the best care possible."

He added: "The technology exists to have these costs available to patients and physicians during the doctor's visit. Unfortunately, physicians rarely have this information, which makes it hard for them to practice in an optimal cost conscious manner."

As with any study, the work had its limitations. For instances, the methods the authors used meant they couldn't confirm the patients weren't adhering to their medications or that out-of-pocket costs were the cause. In addition, the study might not relate to the general population as the data was on a specific group of individuals with private insurance.

However, problems with out-of-pocket costs was also recently highlighted in a paper published in the journal JAMA. In it, researchers found one in five operations may lead to surprise bills for patients in the U.S., even if the hospital or surgeon are in-network.

On average, the potential surprise bill added up to $2,011 in addition to the almost $1,800 the average privately insured patient would owe their insurance company after it paid for most of the costs of their operation.

Karan Chhabra, of the University of Michigan and co-author of that paper, told Newsweek that Congress needs to think about ways to protect patients from these unexpected costs. "We hope this research shows the critical need for such policies and provides a baseline from which to evaluate their success in the future," he said.

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