Consumers economizing on healthcare in ways that might be dangerous: Poll

More than two-thirds (69%) of Americans currently taking a prescription drug say drug makers have too much influence on doctors' prescribing decisions and half say that doctors are too eager to prescribe a drug when other non-drug options are available for managing a condition.  Those are just some of the concerns raised by Americans in a new prescription drug poll by the Consumer Reports National Research Center. More information about the poll is available online at www.consumerreportsenespanol.org.

The nationally representative poll found that nearly half (45 percent) of Americans take at least one prescription drug on a regular basis, and on average, they take 4 medications routinely.

Some other poll highlights gleaned from consumers who currently take a prescription drug:

• Consumers are economizing on healthcare in ways that might be dangerous. In the past year, 39 percent took some action to reduce costs and 27 percent failed to comply with prescriptions. To save money, 38 percent of those younger than 65 without drug coverage skipped filling a prescription.
• Fifty-one percent said they think that doctors don't consider a patient's ability to pay when prescribing a drug.
• Nearly half (47 percent) said they think gifts from pharmaceutical companies influence doctors' choices of drugs for their patients.  
• Four in 10 (41 percent) said they think doctors tend to prescribe newer, more expensive drugs.
• The massive advertising budgets of pharmaceutical companies have an impact on consumers: one-fifth (20 percent) of consumers who take a prescription drug have asked their doctor for a drug they saw advertised, and among them, the majority of doctors issued the requested prescription (59 percent).

The Consumer Reports Health poll also reveals that the public has a strong appetite for more safety information and details about possible side effects:  87 percent said that knowing the safety of a prescription drug was a top priority to them, while 79 percent were concerned about drug interactions, and 78 percent cared about the side effects of a drug.

"Given that so many Americans are taking prescription drugs, and often multiple medicines, we were somewhat reassured by the high priority associated with safety and side effects.  Being attuned to those concerns can help counterbalance the tremendous influence of the drug companies," said John Santa, M.D., M.P.H., director of the Consumer Reports Health Ratings Center.  According to Santa, recent studies, including one published in the Archives of Internal Medicine in August, have shined a light on the poor quality of safety information available to consumers. At least 1.5 million serious, preventable drug errors occur in the U.S. each year.

"The safety information provided on all fronts—in hospitals, at the doctor's office, and the pharmacy—is hit or miss.  When considering a new medication, consumers should ask their doctors about the drug in question, its purported use, how it should be taken, whether certain activities should be avoided, whether drug interactions are possible, and the types of side effects that could occur," said Santa.  Research suggests that doctors are quick to dismiss complaints about side effects.  "Patients should speak up.  Discussing the risks of adverse effects with your doctor will help you prepare for those effects while increasing the chances you'll stay on the drug you need," said Santa.  According to the Consumer Reports Health poll, more than half (53 percent) of Americans currently taking a medication have talked to their doctor in the past 12 months about switching to a different prescription drug, with side effects being one of the main reasons, in addition to cost and lack of insurance coverage.

Adverse effects are understudied according to Dr. Santa, who notes that most research focuses on a drug's benefits rather than potential problems.  Recent reports published by Consumer Reports Best Buy Drugs, a public education project that compares drugs based on safety, effectiveness, and cost, have highlighted several classes of drugs where the risk of side effects can overshadow the benefits of the drug.

Some drug categories that are notable for their side effects include those to treat type 2 diabetes, overactive bladder, and the class of medications known as antipsychotics. Consumer Reports Best Buy Drugs, provides detailed analyses for drugs to treat these conditions, in addition to more than 30 other conditions.  The reports are available for free online at www.ConsumerReportsHealth.org/BestBuyDrugs.

Case in point: A new Best Buy Drugs report that evaluates prescription drugs to treat overactive bladder cites studies which have found that only 10 to 20 percent of people are still taking an overactive bladder medicine after six to 12 months, representing a very high treatment dropout.  It's estimated that cost may be a factor, but about a third to one-half of the dropout is due to side effects.  "The overactive bladder category is really the poster child for drugs that offer limited benefits and a slew of adverse effects.  And they're quite costly," said Santa.   Despite the fact that drugs in this category are only moderately effective, sales have been strong thanks to heavy advertising to the tune of $126.9 million last year for five overactive bladder drugs.  At the same time, drug companies spent $6.6 billion last year alone on promotions to physicians and other health care professionals, according to IMS Health.

SOURCE Consumer Reports