One in seven Americans under age 65 went without prescribed medicines in 2007 as drug costs spiraled upward in the United States, a nonprofit research group said on Thursday.
That figure is up substantially since 2003, when one in 10 people under 65 went without a prescription drug because they couldn’t afford it, according to the Center for Studying Health System Change in Washington, D.C.
The current figure may be even higher because of the recent economic downturn, said Laurie E. Felland, a senior health researcher at the center and lead author of the study.
“Our findings are particularly troublesome given the increased reliance on prescription drugs to treat chronic conditions,” she added. “People who go without their
experience worsening health and complications.”
The people who were least able to afford medicine were often those who needed it most, Ms. Felland said: uninsured, working-age adults suffering from at least one chronic medical condition. Almost two-thirds of them in the survey said they had gone without filling a prescription.
provided by their employers were affected: one in 10 working-age Americans with employer-sponsored coverage went without a prescription medication in 2007, up from 8.7 percent in 2003, the study found.
Among low-income Americans, three in 10 said they had been unable to fill a prescription because of cost, and nearly one in four adults on
or state insurance programs said they’d had difficulty affording drugs.
Ms. Felland said a number of factors contributed to the trend, including rising drug prices, the tendency of physicians to prescribe drugs more frequently, the introduction of expensive new specialty medications, and skimpier drug coverage that shifts a greater share of costs onto patients.
“Insurance coverage offers less financial protection against out-of-pocket costs than it did in the past,” she said.
The study was based on results from the 2007 Health Tracking Household Survey, a nationally representative telephone survey of 10,400 adults under age 65, many of whom also discussed affordability of medications for their 2,600 children. Participants were asked whether there was a time in the previous 12 months when “you needed prescription medicines but didn’t get them because you couldn’t afford it.”
Overall, 5 percent of children didn’t have prescriptions filled in 2007 because of cost, up from 3.1 percent in 2003, and 17.8 percent of working-age adults couldn’t afford drugs in 2007, up from 13.8 percent in 2003, the survey found. That translates into about 36.1 million Americans under 65 who were affected, according to the study.
Karen Davis, president of the Commonwealth Fund, a private foundation that researches health care issues, said the new study confirms previous Commonwealth studies. In 2007, nearly two-thirds of U.S. adults, or an estimated 116 million people, struggled to pay medical bills, went without needed care because of cost, were uninsured for a time or were underinsured, according to the foundation.
“It has become a middle class problem,” she added, noting that improving health coverage is an integral part of economic recovery.
“It’s not enough just to help people have jobs,” she said. “They need to have adequate coverage, so they can get care when they need it and pay the bills they incur when they do seek care.”

Eating more fruits and vegetables, cutting down on calories and carbohydrates and increasing exercise are all-important parts of any healthy diet. But according to new research at the University of Texas Southwestern Medical Center, Dallas, a low-carbohydrate diet burns more excess liver fat than a low-calorie diet.
Researchers in the small clinical study found that people on low-carbohydrate diets are more dependent on the oxidation of fat in the liver for energy than those on a low-calorie diet.
These findings could have implications for treating obesity and other related diseases like diabetes, insulin resistance and nonalcoholic fatty liver disease, says Dr. Jeffrey Browning assistant professor in the UT Southwestern Advanced Imaging Research Center and of internal medicine at the medical center and the study’s lead author.
“Instead of looking at drugs to combat obesity and the diseases that stem from it, maybe optimizing diet cannot only manage and treat these diseases, but also prevent them,” Dr. Browning says.
Glucose, a form of sugar, and fat are both sources of energy that are metabolized in the liver and used as energy in the body. For participants on the low-calorie diet, they received 40 percent of their glucose from glycogen, which comes from ingested carbohydrates and is stored in the liver until the body needs it. However, the low-carbohydrate dieters only received 20 percent of their glucose from glycogen. Instead of using their glycogen reserve, the subjects burned excess liver fat for energy.
“Energy production is expensive for the liver,” Dr. Browning says. “It appears that for the people on a low-carbohydrate diet, in order to meet that expense, their livers have to burn excess fat. Understanding how the liver makes glucose under different dietary conditions may help us better regulate metabolic disorders with diet.”
Although the original study was not designed to determine the effectiveness of one diet over the other, the average weight loss for low-calorie eaters was about five pounds, compared to nine and a half pounds for low-carbohydrate dieters. Results indicated that participants on the low-carbohydrate diet increased fat burning throughout the entire body.

Shopping for lower prices isn’t necessarily the first step you need to take if you want to lower your prescription drug bill, says Michael Cohen, president of the Institute for Safe Medication Practices in Horsham, Penn. First, review the drugs you take (a good practice once each year regardless, doctors say), to determine whether you still need the drug or that dose and whether you could safely substitute a less expensive option for the drug.
A visit with your doctor to review the drugs is your best bet. If you’re concerned about the cost of the visit, you can ask if the doctor will go over your list by phone. (And see below for strategies to reduce the cost of an office visit.) A local pharmacist can also review your drug list and make suggestions to your physician for changes, but never stop taking a drug unless the doctor has specifically given you the OK.
Ask your pharmacist if your particular medicines can be split or if you can use two lower doses to make up the dose you need. Review the costs, including any co-pays. Those options can sometimes save money over the cost of buying the exact dose prescribed. Then . . .
Sure, the corner drugstore may be convenient, but it may also be expensive. According to the National Center for Policy Analysis in Washington, D.C., comparing prices among local pharmacies can save consumers almost 10% on brand-name drugs and up to 81% on generic drugs. You can check comparison prices in your area at
, but also call the local pharmacy to confirm. And some pharmacies may match competitors’ prices. Costco’s prices for brand-name drugs often rank among the lowest, and the warehouse store doesn’t require a membership fee for people buying only prescription medicines.
Don’t assume Internet prices are cheapest. Local pharmacy prices for a 30-day supply of the cholesterol drug Lipitor (80-milligram dose) hovered around $83 recently. The same drug cost $119.99 at
.
This year, many pharmacies, supermarkets and big retail stores such as Walgreens, Ralphs and Target began offering hundreds of generic drugs for as low as $3 per month per prescription. Not all stores offer all generics for the low price, and the list can vary from chain to chain, so check by phone or at the store’s website. CVS charges $10 per year for a savings pass that entitles cardholders to buy 90-day supplies of more than 400 generic drugs for $9.99 each. That fee also gets you some discounts on nonprescription drugs and on visits to its Minute Clinics, staffed by nurses who can give some vaccinations and treat minor illnesses. As the economy continues to falter, expect more deals from drugstore chains. Kmart, for example, lets many customers at most stores buy one of several nonprescription products such as pain relievers and a decongestant for the discounted price of $1 each time you buy a prescription, for a savings of about $3 to $6. Find the website addresses for the stores you frequent and sign up for alerts.
Sixty- and 90-day supplies of drugs are often cheaper by mail order and at retail stores than a 30-day supply. That’s especially true for people with insurance coverage for prescription drugs; buy a 90-day supply and most insurers charge only a two-month co-pay, which can be a savings of at least $20 per year for each generic drug you take, and at least $80 per year for brand-name drugs. Consumer Reports Best Buy Drugs advises checking online prices, for U.S. and foreign pharmacies, at
. Use the price per pill to compare the costs on the site, and factor in the shipping costs that most sites charge. The Food and Drug Administration offers advice at
on buying drugs online through only verified Internet pharmacies.
. Discounts can sometimes apply to co-pays as well.

FARGO (AP) — Parents of Fargo middle school students can soon test their children for drugs.
Project 7th Grade, a Phoenix, Ariz.-based group, provides the kits to school systems, police and other organizations at no charge. The tests rely on urine samples.
Sullivan Middle school is the only school in North Dakota participating in the project, officials said.
“No family, no schools are exempt,” Fargo police officer Mike Clower said. “This is an opportunity to empower parents.”
Clower, the school resource officer at Sullivan Middle School and Shanley High School, is hosting a parents meeting Wednesday to educate parents about drug use among teens.
“There’s a need everywhere,” Clower said. “These are happening in Fargo. I’ve seen it.”
Clower will provide parents with drug use statistics and symptoms, and show them drug paraphernalia so they can recognize what can sometimes be hidden signs. Clower said kids who use drugs typically do so for two years before a parent finds out.
“You think it’s normal adolescent behavior for a while,” parent Marsha Nygaard said. “You ride it out for a while in hopes things get better.”
Clower will give out 50 free drug testing kits to parents Wednesday.
The program and materials are provided by a national organization called Not My Kid, which sponsors a drug prevention course called Project 7th Grade.
“If you get them in middle school, you actually still have a chance to make an impact on a few,” Clower said. Drug use triples between sixth and eighth grade, he said. “It’s a lot harder at the high school level.”
A 2008 Fargo Cass Public Health survey found that about 18 percent of Fargo ninth- through 12th-graders used marijuana last year.