One in 8 adults with common heart diseases and stroke skip taking medications, delay filling prescriptions or take lower doses than prescribed because of concerns about cost, according to new research published today in the American Heart Association’s journal Circulation.

Dr. Bita Kash, professor in the Department of Health Policy and Management at the Texas A&M School of Public Health and director of the Center for Outcomes Research, a partnership between Houston Methodist and the School of Public Health, and colleagues analyzed survey responses from 14,279 adults (average age 65, 44 percent female) who took part in the National Health Interview Survey between 2013 and 2017. All had previously been diagnosed with coronary heart disease, heart-related chest pain, a heart attack or a stroke.

Dr. Kash and colleagues found that, during the previous year:

• 1 in 8 people with these common heart diseases (corresponding to nearly 2.2 million people nationwide) had not taken their medication as prescribed because of cost concerns;
• Cost-related, medication non-compliance was 3 times more common in people under 65 years of age, with nearly 1 in 5 reporting cost-related non-compliance;
• Among those under 65, larger proportions of women (1 in 4), patients from low-income families (1 in 3) and patients without health insurance (more than half) reported not taking their medications as prescribed in order to save money;
• Race and level of education did not have a significant effect on the proportion of patients with cost-related non-compliance; and
• People who did not take medications as prescribed due to cost concerns were 11 times more likely to request low-cost medication and 9 times more likely to use alternative, non-prescription therapies, compared to people who reported that financial concerns did not impact their decision.