Cash-strapped patients still rationing care

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Despite 2011's status as a "breakthrough year" for new pharmaceuticals hitting the market, prescription spending fell, right along with a continued decline in outpatient visits. The reduced spending and visits signal that patients still are cutting back on healthcare due to cost concerns, according to a report from the IMS Institute for Healthcare Informatics.

In the absence of a strong economic recovery, Michael Kleinrock, director of research development at the institute, told The New York Times, "We're now seeing more people reset their expectations about how often they will use medicine."

In particular, the study showed that the number of prescriptions issued to patients declined by 1.1 percent compared with 2010, and visits to the doctor fell by 4.7 percent. Meanwhile, emergency room visits increased by 7.4 percent in 2011, likely among patients who lost jobs and health insurance amid the recession, according to the authors.

The trend appears even more striking among patients age 65 and older, whose prescription use dipped 3.1 percent last year despite shouldering lower out-of-pocket costs through Medicare Part D, the newspaper noted.

A separate article in Florida's Sun Sentinel noted that nationwide, one-quarter to one-third of patients never fill new prescriptions because they can't afford them, fear side effects or don't believe they need them. And with a 9 percent unemployment rate and some 900,000 retirees in the state, the problem of prescription shunning is severe particularly in Florida.

At Light of the World Clinic in Oakland Park, for example, patients frequently walk out of the pharmacy when they find out the price of the drug, Clinic Director Sandy Lozano told the newspaper. But while Lozano's clinic targets uninsured Hispanics, even well-insured patients may be loathe to spend hundreds of dollars a month on a drug they're not convinced they need, added pharmacist Norbert Graber.

"We think we've reached a tipping point, where people are thinking they're paying too much and they're changing their behavior" and getting less treatment, Kleinrock told The Washington Post about the national problem.

To learn more:
- read the article in The New York Times
- see the story from The Washington Post
- read the story from Florida's Sun Sentinel

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