10 Biggest Problems People Have with Their Prescription Meds

Major reasons patients in the U.S. do not take their medications include fear of side effects, confusion as to directions, and simple forgetfulness.

Patients have the right to appeal an insurer decision on their medication. Yet some may forgo the lengthy appeal process altogether and not take the medication. A 2020 report prepared by NPR, the Harvard School of Public Health, and the Robert Wood Johnson Foundation revealed that 48% of middle-income ($35,000 to $99,000) respondents said they were denied coverage for a drug and didn’t fill the prescription, and 51% of those in the lower income bracket (less than $35,000) reported the same.

Generic drugs are often prescribed originally in place of brand-name medications due their cheaper cost. The FDA analyzes generic drugs to ensure their safety, quality, and effectiveness. One meta-analysis reviewed the patient outcomes of a generic versus brand-name cardiovascular drug. In 60% of the studies reviewed, no difference between the two types of drug was exhibited, while 26% showed the brand-name was more effective.

Some pharmaceutical companies will cover part or all of a patient’s copay for certain medications, but insurance companies might not consider those amounts in reducing the patient’s deductible and other costs, discouraging individuals from taking advantage of the programs and thus getting the drugs they need.

The American Medical Association says the top reason patients don’t take their medicines is fear about potential side effects. Cost and not understanding why the drug is needed round out the top three. Other reasons are a lack of symptoms and the feeling that the medication isn’t doing any good.

A survey of primary care patients in Germany revealed nearly 24% split their pills. Patients may do this to lower their overall monthly costs or to lessen what they feel is an excessive dose. Doctors and pharmacists advise against cutting pills in half. However, according to the Cleveland Clinic, it can be done with a pill that has a line or score down the middle, providing the doctor or pharmacist allows it. Extended-release medication or oddly shaped pills should not be cut in half.

A study in the Journal of the American Pharmacist Association estimated 90% of Americans live within five miles of a community pharmacy. Yet the association noted that access to pharmacies varies widely across the country, so in some areas, it may take time for the patient to get to the pharmacy or send someone to pick up the prescription. Once the prescription is in hand, patients might put off taking it due to fear, confusion, or other factors.

Some people don’t fill their prescriptions because they can’t afford to, or because they don’t want to take the medication for a variety of reasons. Even if they do fill it, though, lack of transportation may be a major barrier to obtaining it. The problem was more acute in minority populations.

Prior authorization is required for medications under many insurance plans. Through the process known as “step therapy,” a patient must take the preferred drug for a medical condition and experience no benefit from it before another medication is prescribed.

A 2020 report prepared by NPR, the Harvard School of Public Health, and the Robert Wood Johnson Foundation surveyed people across all income classes. More than three in 10 in all groups reported they or a household member were told their insurer would not cover a prescription written by their doctor.

Waiting for a prescription can cause adverse events. One-third (34%) of physicians responding to a recent AMA survey reported the prior authorization process led to hospitalization, disability, or even death, for a patient in their care. In addition, 82% reported that some patients abandon treatment due to authorization delays and struggles with health insurers.

Prescription medications can successfully treat many chronic conditions. Unfortunately, for all the good they do, they also come with side effects that could lead some patients to skip doses, which lessens the effectiveness of the drug. Common side effects include: constipation, skin rash, diarrhea, dizziness, dry mouth, insomnia, nausea, drowsiness, and headaches. Patients might also skip doses out of forgetfulness.