The cost of medication to treat asthma, the chronic lung disease, is stopping one in six US adults from taking their medication as it has been prescribed, researchers warned Monday.
Furthermore, failure to stick to drug treatment was associated with nearly doubling the risk of an asthma attack and a more than 60 percent heightened risk of visiting an emergency department, they said.
“Adults with asthma who reported experiencing cost-related medication non-adherence had a higher likelihood of experiencing asthma exacerbations,” Emily Graul and Dr. Christer Janson — of the Emory University School of Medicine and Sweden’s Uppsala University, respectively — explained in an editorial article linked to the research. Graul and Janson were not authors of the study.
The peer-reviewed findings were published Monday in the journal Thorax.
Asthma causes wheezing, breathlessness, chest tightness, and coughing. While it can be genetic, not all cases are inherited and environmental factors like air pollution can be additional triggers.
Asthma attacks, which occur when the sides of the airways in the lungs swell and the airways shrink, typically happen when something bothers the lungs. And, severe asthma attacks can be life-threatening.
Asthma can be treated using medications, lifestyle treatments, and inhalers. Inhalers are handheld devices that get medicine directly into peoples’ lungs. While Americans with asthma are more likely to have health insurance, the agency says most adults aged 18 to 64 report cost barriers.
The prices of inhaled medicines have increased by an average of 50 percent since 2009, according to the Asthma and Allergy Foundation of America. The cost of inhalers ranges between tens and hundreds of dollars, with some companies agreeing to a $35 cap earlier this year.
On average, 10 people in the US die from asthma each day and more than 3,200 people died in 2022, the foundation said. An estimated 22 million American adults had asthma in the US that year, according to the Centers for Disease Control and Prevention.
Nearly 30,800 US adults with asthma were included in the study. Its authors, who were from Taiwan’s Taipei Medical University and the University of Michigan College of Pharmacy, used survey responses taken between 2011 and 2022.
Participants were asked if they had skipped medication doses, had taken fewer doses, or delayed repeating their prescriptions to save money over a period of a year. They were also asked if, during that same time, they had an asthma attack or associated episode or had to visit an emergency or urgent care center because of their asthma.
Of those respondents, 18 percent said they couldn’t afford to take their meds as prescribed, which BMJ Group said was equivalent to just short of 3 million of the US population with the condition. Furthermore, 12 percent said they had skipped medication doses, 12.5 percent reported that they took fewer doses, and 15 percent said they had delayed repeating their prescription.
While the number of those citing cost as a reason for not sticking to their treatment regimen fell significantly from 2011 to 2022 — from 23 percent to 13 percent — that still left the equivalent of one in six adults with asthma citing financial hardship as the reason for not taking their meds as prescribed in 2022.
Women, Black people, and people between the ages of 18 to 60 years old were more likely to report not taking their medications as prescribed because of the expense.
Other influential factors included living in southern states, lower education, a lack of health insurance, low household income, co-existing conditions, and living alone.
Because this is an observational study, they said no firm conclusions can be drawn about cause and effect. Still, they suggested that the
“With fewer barriers to accessing healthcare, including medications, patients may be more willing to fill prescriptions for medications to control their asthma than before,” they suggest.
Graul and Janson said that while the Inflation Reduction Act’s associated Medicare Drug Price Negotiation Program lowered drug costs for several chronic conditions, it has not yet included drugs for respiratory conditions.
“The results of this study beg the question: should certain asthma medications be part of the next batch of drug negotiations?”