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Americans are skipping medically necessary prescriptions because of the cost

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For many Americans, the cost of regularly taking and filling their medications is too much. So much so, 44% of respondents in a new online poll say that within the last year, they did not purchase at least one medically necessary prescription because of cost.

That's according to an online flash poll of over 1,000 U.S. adults conducted by PawnGuru​, an online marketplace that conducts regular surveys on a range of topics affecting low-income and under-banked Americans.

That's higher than previous polls that have found Americans struggling with prescription drug costs. A similar 2018 survey by GoodRx found that about a third of Americans admitted they have skipped filling a prescription one or more times because of the cost.

Last year, Kaiser Family Foundation found 29% of Americans failed to take their medications as prescribed because of the cost, with about 19% of respondents saying they did not fill the prescription and 12% saying they cut pills in half or skipped a dose.

Overall, nearly six in 10 Americans report taking at least one prescription drug, according to Kaiser. Unsurprisingly, the more prescriptions you have, or the more each drug costs, the harder it becomes to afford.

In the latest PawnGuru poll, about 20% of respondents say they're currently paying more than $100 a month out of pocket for their prescriptions. And 40% of those surveyed say their insurer has declined to cover a prescription at least once in the past year.

Across the board, the cost of prescription drugs rose 3% year-over-year from December 2018 to 2019, according to the Bureau of Labor Statistics's Consumer Price Index. And individual drug costs can be even higher. The cost of Humira, which is used to treat rheumatoid and psoriatic arthritis, increased by 7.4%, according to GoodRx. Birth control medication Lo Loestrin FE increased by 5% and psoriasis treatment Cosentyx increased by 17.59% between 2019 and 2020.

In fact, GoodRx found that over 100 manufacturers raised the price for 619 brand-name drugs by an average of 5.2% in January 2020.

Source: GoodRx list price index, a model that tracks list price changes. According to the model, the average list price for brand and generic medications has increased by 33.6% since 2014.

Refusing to purchase costly drugs can have real health consequences. There are about 125,000 deaths per year in the U.S. due to medication non-adherence. Additionally, not adhering to recommended medications to treat chronic diseases can actually increase your overall health care spending because you may need more expensive treatments as opposed to just maintenance, according to research from the Centers for Disease Control and Prevention. Overall, the CDC estimates this costs Americans about $300 billion a year.

How consumers can bring the cost down

Over the past year, several pieces of legislation have come close to passing Congress that contain drug pricing reforms, including the Lower Drug Costs Now Act that passed the House in December and is now awaiting a vote in the Senate.

But while legislation lags, there are steps that many consumers can take now to lower their out-of-pocket costs. "Most of what people need isn't high cost," Carolyn McClanahan, a Florida-based financial planner and physician, tells CNBC Make It. "It is those with specialty problems that run into trouble — rheumatological disease, other autoimmune diseases or advanced heart disease."

If you do have multiple prescriptions, or have expensive medications, McClanahan recommends looking into your options. It's usually cheaper to get a 90-day supply, or you can check with your doctor to see if your medication comes in a higher dosage that you can use a pill cutter to cut and take half a dosage.

"Often the higher doses are the same price as lower doses, so you can double the number of pills you get for the same price, if the pills are cuttable," McClanahan says. Most important, tell your doctor if you are having trouble affording your medications, she says. Some don't pay attention to costs unless you tell them that's a concern.

Also ask if there's a generic option. "Generic medicines are just as effective as their name-brand counterparts at treating illnesses or helping maintain health, but they cost much less," Tori Marsh, a health insights analyst for GoodRx, tells CNBC Make It. Generic medicines cost, on average, 80% to 85% less than a name-brand equivalent, according to the U.S. Food and Drug Administration.

For expensive drugs that don't come in a generic formula, check to see if the pharmaceutical company has an assistance program. If you're not sure if the company offers discounts, you can Google the name of the pharmaceutical company that distributes each medication you are on plus "patient assistance" to find each one you'd need to apply for.

This can be an especially money-saving route for high-priced, specialty drugs. "You have to do a lot of paperwork, but totally worth it," McClanahan says.

No matter what type of medication you are taking, you should also always shop around for the best price. Websites and apps such as GoodRx, Blink Health, Singlecare and RXSaver can help you locate pharmacies with cheaper discount programs and even coupons. Plus, if you are member of AAA or shop at a wholesale club, you may be eligible for discounts and savings.

Costco, for example, has a member prescription program that offers discounts on generic and brand-name medications. While exact prices can vary, drugs at Costco can save you up to 80% off what you'd pay for the same medications at other pharmacies, even without insurance, the Krazy Coupon Lady site reports. Costco was also the cheapest walk-in pharmacy when it came to non-member prices on five common prescription drugs, Consumer Reports found.

It also may be worth considering paying cash instead of using insurance. While this means the drug payments won't go to your deductible, several grocery and big box stores such as Walmart, Winn Dixie and Publix have $5 drug lists, which offer any medication on that list for just $5 without insurance.

There are also government savings programs you may be eligible for. To evaluate your options, check out Benefits.gov and USA.gov to find and apply for government benefits like Medicaid, Health Care for Children and Medicare. Your state may also have its own health care programs to help with medical bills and costs.

Last, consider using a health savings account or health flexible spending account. "Open a savings account to stash extra cash earmarked only for medical costs," Marsh says. "While it may be tempting to dip into this account for a vacation or credit card payment, make sure to only use the funds when you have a medical expense."

Especially since Marsh says consumers should expect more prescription price increases in July 2020, when manufacturers typically tend to increase the price of their drugs.

Correction: A map in a previous version of this story contained incorrect information.

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