Ill effects of cutting back on medications

Middle-aged and elderly people who cut back on their prescription medications to save money or because they cannot afford them are more likely to suffer significant declines in health in the next few years, including heart attacks, strokes and chest pain, than those who take their medications as prescribed.

A team of Ann Arbor, Mich., researchers studied the health reports of 8,000 adults older than 50 between 1995 and 1998. About 7% said they had cut back on their medications because of the cost. Of those, about 32% had experienced a serious decline in health, compared with 21% of those who had not cut back on medications.

The adults most likely to suffer ill effects were those with cardiovascular disease. They were 50% more likely to have a nonfatal stroke or heart attack or angina than those who continued taking their medications as prescribed. People older than 65 with cardiovascular disease were more likely to suffer adverse effects than their counterparts who continued their medication.

(The study adjusted for possible confounding factors including health status, smoking, alcohol consumption and obesity.)

The results should be considered in the national debate over pharmaceutical costs and how much the government should pay for them, said lead researcher Dr. Michele Heisler, who suggests that the government should consider the cost of not providing drugs to those most at risk -- those with cardiovascular disease.

“If you don’t cover the costs [of the drugs], the costs to the community and society will be much greater downstream,” she said. “They will have more heart attacks and strokes. Statins, beta blockers and ace inhibitors -- these are the medications that have a huge impact on preventing illness and death.”

The study, published in the July issue of the American Public Health Assn.’s journal, Medical Care, was funded by the National Institute of Aging.