Medication cost problems among chronically ill adults in the US: did the financial crisis make a bad situation even worse?

Figures & data

Table 1 Sample description

		Age
		40–64	65+
N	27,302	17,787	9,515
Employment status
Employed	13,606	64.4	22.3
Unemployed^a	838	4.1	4.1
Not looking	2,251	12.4	n/a
Retired	10,348	17.3	76.5
Disabled and unable to work	259	1.8	n/a
Female	14,572	53.7	58.1
Race
White	25,437	88.3	96.0
Black	616	6.1	2.0
Hispanic	202	2.4	1.0
Other	1,047	3.2	1.2
No college degree	15,572	65.0	71.9
Annual income <$50,000	13,067	42.6	57.7
Fair/poor health	9,427	34.2	26.8
Number of chronic conditions
1	7,298	34.8	24.2
2–3	15,746	53.5	64.0
4+	4,258	11.7	11.8

Notes: Percentages within age groups were calculated using sampling weights to estimate proportions within the US non-institutionalized population aged 40 and older. All differences between age groups were statistically significant (P < 0.001).

a Unemployed and looking for work.

Table 2 Adjusted* percentage of respondents reporting medication-cost problems in 2008 and reporting an increased frequency of cost problems in 2008 compared to 2007

	All ages (N = 27,302)		40–64 (N = 17,787)		65+ (9,515)
	2008	Increase	2008	Increase	2008	Increase
Any cost-related non-adherence	44.2%	21.4%	49.6%	24.8%	30.3%	12.6%
Delayed filling	34.3	16.5	39.8	19.6	20.0	8.5
Split or took fewer pills	33.9	15.0	38.0	17.7	23.2	8.0
Did not fill a new Rx at all	24.0	10.4	28.5	12.5	12.5	4.8
Stopped taking Rx altogether	18.7	8.3	22.3	10.0	9.4	3.8
Any other financial hardships	51.2	27.0	54.9	30.1	41.5	19.1
Spent less on discretionary activities	45.8	22.7	49.0	25.0	37.4	16.6
Spent less on necessities	32.5	14.8	36.0	17.1	23.4	8.8
Increased credit card debt	23.9	11.3	26.4	13.0	17.7	6.9
Borrowed from family or friends	12.6	5.3	15.9	6.7	4.1	1.7

Notes: Cell entries represent column percentages. “Increases” represent the proportion of all respondents reporting both CRN in 2008 and that the problem had become more frequent than in 2007. Estimates were calculated using sampling weights to approximate the proportion within the US non-institutionalized population aged 40 and older.

* Estimates were adjusted for age and sex. All differences between age groups were statistically significant (P < 0.001).

Abbreviations: CRN, cost-related medication non-adherence; Rx, prescription.

Table 3 Adjusted* percentage of respondents 40–64 years of age reporting medication-cost problems in 2008 and reporting an increased frequency of cost problems in 2008 compared to 2007 (N = 17,787)

	Employed (ref)		Looking for work		Not looking		Retired		Disabled
	2008	Increase	2008	Increase	2008	Increase	2008	Increase	2008	Increase
Any cost-related non-adherence	47.5%	22.3%	65.8%^a	38.8%^b	52.0%^a	25.7%^b	50.0%	26.0%^b	57.2%	26.9%
Delayed filling	37.2	17.5	56.2^a	29.8^b	40.4	19.6	40.8^a	20.4	48.8^a	22.6
Split or took fewer pills	36.4	15.7	49.7^a	25.8^b	39.8	18.1	36.8	18.8	41.7	19.0
Did not fill a new Rx at all	25.2	10.4	40.7^a	21.1^b	30.7^a	12.0	30.2^a	14.3	35.5^a	10.4
Stopped taking Rx altogether	19.4	8.2	34.3^a	19.6^b	23.8^a	10.2^b	24.5^a	10.6	27.0^a	11.0
Any other financial impact	52.6	27.9	66.1^a	36.3^b	56.4^a	29.9	58.6^a	33.8	63.8^a	34.4
Spent less on discretionary activities	46.6	23.1	62.3^a	31.6^b	49.1	24.4	52.6^a	28.5^b	58.6^a	26.9
Spent less on necessities	32.5	14.8	47.6^a	24.5^b	38.3^a	17.2	41.6^a	20.6^b	43.1^a	19.8
Increased credit card debt	26.0	12.5	28.9	14.5	25.6	13.6	27.0	13.2	27.1	13.8
Borrowed from family and friends	11.0	4.8	23.0^a	9.3^b	20.3^a	6.9^b	20.8^a	8.3^b	27.1^a	7.9

Notes: Cell entries represent column percentages. “Increases” represent the proportion of all respondents reporting both CRN in 2008 and that the problem had become more frequent than in 2007. Estimates were calculated using sampling weights to approximate the proportion within the US non-institutionalized population aged 40 and older.

* Estimates were adjusted for age and sex;

a Indicates that the 2008 proportion in that employment group was statistically different (P < 0.05) than the 2008 proportion for employed respondents;

b Indicates that the percentage of patients reporting an increase in CRN was statistically significantly different in that employment group relative to employed respondents. “Employed” respondents reported that they were employed full-time, part-time, or self-employed. The group of respondents “Not looking” for a job included respondents reporting that they were students or a stay-at-home “spouse, partner, husband, or wife”.

Abbreviations: CRN, cost-related medication non-adherence; Rx, prescription.

Table 4 Adjusted* percentage of respondents 65+ years of age reporting medication-cost problems in 2008 and reporting an increased frequency of cost problems in 2008 compared to 2007 (N = 9,515)

	Retired (ref)		Employed		Looking for work
	2008	Increase	2008	Increase	2008	Increase
Any cost-related non-adherence	28.7%	11.4%	34.0%^a	14.3%^b	43.2%	17.9%
Delayed filling	18.1	7.3	23.2^a	9.9^b	35.6^a	15.1
Split or took fewer pills	22.0	7.3	26.5^a	8.7	26.5	11.0
Did not fill a new Rx at all	11.3	4.2	13.4	5.3	26.7^a	9.2
Stopped taking Rx altogether	8.7	3.2	9.8	4.3	17.7	5.7
Any other financial impact	39.9	17.5	45.3^a	21.7^b	59.3^a	35.5^b
Spent less on discretionary activities	35.7	15.2	41.3^a	18.8^b	58.4^a	27.1
Spent less on necessities	22.0	7.6	25.6	10.4^b	34.3	12.5
Increased credit card debt	16.2	5.7	21.6^a	9.1^b	29.3	13.9
Borrowed from family and friends	3.7	1.4	3.7	1.4	12.3	11.0^b

Notes: Cell entries represent column percentages. “Increases” represent the proportion of all respondents reporting both CRN in 2008 and that the problem had become more frequent than in 2007.

* Estimates were calculated using sampling weights to approximate the proportion within the US non-institutionalized population aged 40 and older. Estimates were adjusted for age and sex;

a Indicates that the 2008 proportion in that employment group was statistically different (P < 0.05) than the 2008 proportion for retired respondents;

b Indicates that the percent of patients reporting an increase in CRN was statistically significantly different in that employment group relative to retired respondents. “Employed” respondents reported that they were employed full-time, part-time, or self-employed. “Retired” respondents included those who reported that they were unemployed but not looking for work, students, stay-at-home partners, or disabled and unable to work.

Abbreviations: CRN, cost-related medication non-adherence; Rx, prescription.