Cost-Related Medication Underuse Among Chronically III Adults: the Treatments People Forgo, How Often, and Who Is at Risk

Piette, John D.; Heisler, Michele; Wagner, Todd H.

doi:10.2105/ajph.94.10.1782

Cited by 349Economic and Financial Impacts of CancerMedication Adherence and ComplianceHealthcare Policy and Management

Cost-Related Medication Underuse Among Chronically III Adults: the Treatments People Forgo, How Often, and Who Is at Risk

Piette, John D., Heisler, Michele, Wagner, Todd H.·2004·American Journal of Public Health

DOI 10.2105/ajph.94.10.1782

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Abstract

Objectives. We sought information about the cost-related underuse of medications—which medications are underused, by whom, and how often. Methods. Chronically ill adults were asked to identify how often they underused prescription medication for 16 health conditions because of the cost. Results. Eighteen percent of respondents cut back on medication use owing to cost in the previous year, and 14% used less medication at least monthly. Although rates of underuse varied substantially across treatments, prescription coverage and out-of-pocket costs were determinants of underuse across medication types. Conclusions. Many chronically ill adults frequently cut back on medications owing to cost. Patients are selective about the treatments they forgo. Out-of-pocket costs and inadequate prescription coverage may lead to adherence problems for many important medication types.

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In a study of patients with chronic disease, two-thirds of those who reported not taking medications as prescribed due to cost never shared this with their physician.
“In a study of patients with chronic disease, two-thirds of those who reported not taking medications as prescribed due to cost never shared this with their physician [30,31].”
From Impact of Social Determinants of Health and Demographics on Refill Requests by Medicare Patients Using a Conversational Artificial Intelligence Text Messaging Solution: Cross-Sectional Study (2019) · cites this paper as [31]

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Authors: Piette, J. D., Heisler, M., & Wagner, T. H.
Affiliations: United States Department of Veterans Affairs (US)
ORCID: Piette, John D.
Heisler, Michele
Wagner, Todd H.
Venue: American Journal of Public Health
Publisher: American Public Health Association
Published: 2004-10
Volume: 94
Issue: 10
Pages: 1782-1787
ISSN: 0090-0036 (ISSN-L)
1541-0048
DOI: 10.2105/ajph.94.10.1782
OpenAlex: W2161088956
Cited by: 349
References: 17
Citations by year: 2026: 3 · 2025: 9 · 2024: 2 · 2023: 7 · 2022: 15 · 2021: 15 · 2020: 17 · 2019: 18 · 2018: 17 · 2017: 16 · 2016: 22 · 2015: 22 · 2014: 18 · 2013: 19 · 2012: 19
FWCI: 38.69
Type: journal article
Language: en
Open access: closed
Locations: American Journal of Public Health (publishedVersion)
PubMed (publishedVersion)
DigitalGeorgetown (Georgetown University Library) (submittedVersion)
Funders: Health Services Research and Development
Topics: Social Sciences › Economics, Econometrics and Finance › Economics and Econometrics › Economic and Financial Impacts of Cancer
Health Sciences › Medicine › Family Practice › Medication Adherence and Compliance
Social Sciences › Economics, Econometrics and Finance › Economics and Econometrics › Healthcare Policy and Management
Keywords: prescription drug costs, out-of-pocket costs, medication adherence, chronic disease, health care costs
MeSH terms: Aged, Chronic Disease, Female, Financing, Personal, Health Services Research, Humans, Male, Middle Aged, Patient Compliance, Drug Prescriptions, Socioeconomic Factors, United States, Drug Costs, Cost of Illness, Drug Utilization Review

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Cost-Related Medication Underuse Among Chronically III Adults: the Treatments People Forgo, How Often, and Who Is at Risk

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