Roanoke Times
Copyright (c) 1995, Landmark Communications, Inc.
DATE: THURSDAY, November 25, 1993 TAG: 9311260046
SECTION: NATL/INTL PAGE: A-30 EDITION: HOLIDAY
SOURCE: Associated Press
DATELINE: WASHINGTON LENGTH: Medium
Many Americans skip doses, abandon their medicine early or don't even get prescriptions filled - traits that keep them sick and have caused a surge in drug-resistant diseases.
The problem is an old one, but the Task Force for Compliance, a consortium of 22 pharmaceutical companies, put a price on it for the first time.
It found missing medicine caused:
At least 10 percent of hospital admissions, costing $25 billion.
$50 billion in lost productivity.
10 percent of nursing-home admissions, costing $5 billion.
$20 billion in premature death and treatment for ambulatory patients.
"The patient has a responsibility for how he or she takes drugs that enhances not only their health, but the health of the nation," said Dr. Hazle Shorter, who chairs the task force.
The task force says doctors and pharmacists don't explain how to take medicine or stress the importance of finishing all those pills, and wants them to communicate better.
The American Association of Retired Persons says the main problem is the industry's high prices.
Buying medicine is a financial burden for 58 percent of Americans 45 or older, said the AARP's Dan Durham. Ten percent say prescription costs force them to cut back on food or heat.
President Clinton's plan to include prescription drugs under Medicare will help, Durham said. And the AARP is pushing for prescription coverage for everyone with a ceiling on drug prices.
But the drug industry is right that patients have to change their behavior too, said Dr. Mark Monane of Brigham & Women's Hospital in Boston. Up to 50 percent of Americans buy prescriptions but skip doses, quit taking medicine too early or don't even take the first dose.
Improper medication doesn't just cause trouble. Tuberculosis patients' quitting their medicine early has caused a surge in drug-resistant strains of the lung disease. The government now recommends doctors actually watch patients take TB therapy. In New York City, that has meant virtually incarcerating some patients - an expensive proposition.
"Many people call noncompliance the hidden epidemic," Monane said. "Patients don't say, `Gee doctor, I didn't take my medicine,' and doctors don't ask."
The task force is telling doctors they should always ask patients about how they take medicine and explain to them why it is prescribed and the consequences of taking it improperly. It is preparing a pilot project that will document whether teaching doctors how to educate Medicaid patients boosts compliance and lowers health-care costs.
Monane says showing patients how much they'll pay in hospital bills versus the pharmacy bill may be key.
by CNB