The $10 Dilemma

Ralph arrived at the ER with his blood pressure extremely elevated, his head and heart beating frightening hard and fast.  Controlling his blood pressure and relieving his symptoms were accomplished easily with medication soon after his arrival.  The attending physician, Dr. Lee, spent additional time with Ralph once he was stable to try to identify what caused this crisis was because Ralph had already been prescribed the type of medication that rapidly corrected the problem.  Reluctantly, Ralph admitted that he had run out of his medication and until his payday the following week, he did not have the $10 needed for the co-pay.  Dr Lee called me aside, handed me a prescription for Ralph’s medication then opened his own wallet and handed me a ten dollar bill to cross the waiting room to the pharmacy and obtain a month’s supply of the medicine needed to control Ralph’s blood pressure. 

Ten dollars prevented what would have in all likelihood progressed to a stroke or heart attack for Ralph.  The cost of hospitalization due to a stroke or heart attack, the potential loss of work and the possibility of permanent disability far exceeded the cost of the co-pay.  But in Ralph’s case, finding $10 was an insurmountable challenge that nearly caused a catastrophe.

Running out, skipping or splitting doses and sharing medications are all common and extremely dangerous actions individuals and caregivers may take to save money.  Many of these same individuals have chronic conditions, such as high blood pressure, heart disease and diabetes.  When they do not take their medications as prescribed, new health problems may develop; for example, the individual with high blood pressure may develop kidney disease or have a stroke or heart attack. 

As many as 20% of Americans do not take their medications as prescribed because they cannot afford them.   Individuals need to be honest with their health care providers if they are having money concerns that affect their health care needs.   Providers need to ask their patients if they can afford to fill their prescriptions and follow-up to ensure that the medications are being obtained and utilized as ordered. 

There are assistance programs available to make medications more affordable.  Pharmaceutical companies, insurance providers, state agencies, disease support groups and senior centers are often great resources for those needing assistance.  Discharge planners at facilities, community social workers and home care staff as well as physician offices can assist in initiating this process of medication compliance.  Online sites that may also help obtain prescription assistance include www.rxassist.org, www.needymeds.org, www.rxhope.com, and www.pparx.org.