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Tons of turned-in, unwanted medication shows public health risk resulting from not following doctors' orders

New Hampshire Union Leader
Sunday News Correspondent

May 04. 2013 7:18PM

When Granite Staters dropped off more than 2 tons of unwanted or unexpired prescription medications during a dedicated day last weekend, it was a symptom of a $329 billion annual problem plaguing the nation's health care system.

And the cure?

People taking their medication as prescribed until their doctors tell them to stop.

"If you've paid for the prescription, you've already put that money out there, but when you get really big problems is when folks with chronic conditions get off schedule, it can really cause complications," said Scott Larrivee, public relations director for Anthem Blue Cross and Blue Shield, the state's largest private insurer.

The issue cost New Hampshire residents an average of $1,110 each last year compared with $1,342 for every American, according to a recently released study from Express Scripts, which manages more than a billion prescriptions each year for tens of millions of patients. (New Hampshire ranked the sixth-lowest in average cost; Vermont came in the lowest, with Massachusetts the seventh-lowest and Maine the ninth-lowest).

The $329 billion figure for 2012 was up 4 percent from the $317 billion estimate for 2011.

The higher costs come as a result of people developing more serious medical problems - requiring more health care for such things as diagnostic tests, surgeries and hospitalizations - than they would have had if they had adhered to their prescription regiment, according to David Whitrap, director of Express Scripts.

Larrivee said health insurance companies don't like spending money on medications that just get thrown away, leading to costly treatment down the line.

"It's definitely a big issue when you talk about medical waste and unnecessary costs that we can avoid," Larrivee said.

He suggested using devices such as dated pill boxes, written reminders or digital alerts.

Whitrap said 69 percent of the people said not taking medication as prescribed was "simple forgetfulness and procrastination." An additional 16 percent not taking medication as directed blamed it on medication costs, with the remaining 15 percent attributing it to clinical questions, such as experiencing a drug interaction or side effect, he said.

But skipping medications comes at a huge cost.

"If you think of non-adherence as a medication condition in and of itself, we spend more money on that than we do on cancer, diabetes and heart disease combined," Whitrap said Friday.

Whitrap said almost $60 billion of that cost would be eliminated if people filled their prescriptions through home delivery, which would help them stay on their schedule.

Citing previous studies, the New England Health Institute, a health policy institute in Cambridge, Mass., said health care spending for a diabetes patient paying little attention to taking his or her medicine cost twice as much as a patient using medication as directed. One 2005 study said up to half of the 187 million Americans who took one or more prescription drugs didn't take them as prescribed.

During National Prescription Drug Take-Back Day on April 27, 5,681 pounds of unwanted or expired prescription medications were dropped off at more than 70 New Hampshire locations.

The amount - equivalent to the weight of two Volkswagen Beetles - was 26 percent more than was collected at a similar event last September, according to figures from the U.S. Drug Enforcement Administration.

More than 60 people, including Rod Christy of Peterborough, dropped off medications at the Peterborough Police Department.

"I was prescribed medication after a surgery, and I just didn't find it was very effective," he said, adding with a laugh that he hopes his surgeon doesn't read about this.

Pam Workman of Hancock is caring for her elderly parents and had a bag of prescription drugs that had been prescribed to her mother in the course of her mother's physicians attempting to stop a pain in her side.

"She has several doctors," Workman said.

"Some of these things didn't agree with her, so she stopped (taking them)," she said. "I said, 'Mom, what are you doing with all of these?' And she said, 'I'm not taking them.'"

Robin Haubrich of Francestown is allergic to bees and brought in five years' worth of expired EpiPens. She needs the EpiPen on hand, but it expires after a year and she needs to dispose of it.

Kenneth Belcher of Peterborough brought in a box full of prescription drugs.

"This goes back to about 2004," he said.

None of the drugs had been prescribed to him but rather to family members who suffer from long-term conditions. The doctors are constantly switching the medications, he said, so you are left with bottles of drugs no longer prescribed.

It's the same for many dropping off prescriptions.

"A lot of it was a change in medication," said Jane Varnum of Greenfield.

Reporter Dave Solomon contributed to this story.

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