The economic burden of prescription drug use among elderly patients in Ponce, Puerto Rico

Abstract

Objective: To examine the economic impact of prescription drug use on the personal income of elderly individuals in Ponce, Puerto Rico.

Methods: One-hundred elderly individuals who attend five care centers were interviewed using a four-page structured questionnaire. The interview collected information about the source and amount of income of participants, the type of insurance coverage for prescription drugs, the amount of expenditures for prescription drugs that are paid out-of-pocket and the barriers they face to use or obtain prescription drugs.

Results: Participants were mostly female (69%) and the average age was 77 years. The average monthly income reported was 476 dollars, 79% of which was derived from Social Security. The average monthly expenditure was 364.00 dollars of which 117.00 dollars (32%) was spent on health related expenditures: 70.00 dollars (19%) on prescription drugs, 31.00 dollars (8%) on health insurance premiums, 10.00 dollars (3%) on medical expenditures not related to prescription drugs, and 6.00 dollars (2%) on over-the-counter drugs. The great majority reported having health insurance but one-third pay out-of-pocket for their prescription drugs. Nearly two-thirds expressed they have experienced problems to obtain or use medications in the past six months. Thirty-eight percent reported that the problem was that the cost of medications was too high.

Conclusion: In spite of insurance coverage, the cost of prescription drugs places a substantial economic burden on elderly individuals. On average, prescription drug expenditures comprise nearly 20% of the personal expenditures of respondents, second only to groceries. This accounts for 15% of their personal income. The economic burden of prescription drugs on the elderly may affect access to needed drugs and may adversely impact health outcomes.