Free Prescriptions with Dr. Bonnie Braun

With the economy in dire straits, families everywhere are forced into making difficult choices that can have detrimental effects on their health--including whether or not to fill their often expensive prescriptions for medicine.

In response to this, some supermarkets and pharmacies, including local chains Giant and Wegman’s, have started offering many commonly-filled prescription drugs (such as amoxicillin, penicillin and ciprofloxacin) at no cost. Here’s an excerpt from a recent Washington Post article on the move:

This is the first time that Giant has offered free prescription drugs and it did not estimate the cost or potential popularity of the program.

"Times are tough," said Robin Michel, executive vice president for Giant Food, which is based in Landover. "If this is the way that we can help most people, why not?"

The economic downturn has made it increasingly difficult for many Americans to afford prescription drugs. An October survey by the Kaiser Family Foundation, a nonprofit health policy group, found that 27 percent of people did not fill a prescription in order to save money, compared with 23 percent just six months earlier. About 22 percent reported cutting pills or skipping doses, up from 19 percent.

For more on this trend, and how choosing not to take prescriptions can affect family health, we turned once again to Dr. Bonnie Braun, who serves as the endowed chair and director of the Herschel S. Horowitz Center for Health Literacy.

The Healthy Turtle: Does this trend have a particular name? What are the dangers involved in avoiding filling prescriptions?

Dr. Bonnie Braun: Yes--Not taking prescriptions is called noncompliance. Noncompliance, especially among lower income individuals and families and those with poor health, increases the risk of additional health problems and costs. The trend does not bode well for the individuals, their families and society who may well bear the financial cost of more expensive treatments.

Noncompliance is often behind emergency room visits which increases health problems and both personal and societal costs. Noncompliance is a risk factor for all income levels but especially so for lower income persons with health problems. There may be a short term cost avoidance but a long-term increase in financial and personal costs.

HT: Beyond just saving them money, what impact do programs like Giants' have on families with low-income families? Are there risks as well as benefits?

Dr. Braun: Programs that subsidize the expense of prescriptions are supporting both the individual and their families as well as society. They contribute to extending personal finances and to potentially decreasing additional health costs. However, those programs can also cease just as they are started by conscious decisions of the business managers.

While altruism does exist and is likely a driver for this kind of program, I wonder if there isn't a business perspective that may not be realized. If more people come to their stores for the medicine, then the increased traffic is likely to increase other purchases at the store. Depending on what those items cost, there may or may not be a financial savings for the individual and family.

Still for the short run, likely the benefits outweigh the costs.

HT: In general, what are the challenges that low-income families face when they are sick?

Dr. Braun: My own research has demonstrated that the health challenges are many. Depending on their race, ethnicity, gender, geographic location, many face health disparities.

For those who are employed, being sick often means not working and not earning a paycheck. Many do not have sick leave. Often, they do not have health insurance and even if they do, they may not have prescription drug insurance. Faced with earning to meet their basic needs and those of their families, they often delay dealing with the health problem, and delay tends to lead to more severe problems.

If children are involved, the breadwinner may have to make a choice between working and caring for the child. Sometimes, the care-giving is for an older adult or a family member with disabilities. Tough choices for anyone, and especially for those with low-incomes.

For some, being sick presents an access problem. Getting to a place of care at a time that fits into their schedule is challenging, especially so if private transportation isn't available or if it is, the cost of driving to the care also takes away from earned income.

HT: What about families with low health literacy?

Dr. Braun: Research finds that low health literate patients exhibit less compliance with prescriptions and have poorer health outcomes. Health literacy pays both during prevention phases and during an acute or chronic illness. Risk assessment is one health literacy competency. Health literate people understand the concept of the risks they face when not following recommended procedures or taking prescriptions as instructed.

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Dr. Bonnie Braun is the Endowed Chair & Director of the Herschel S. Horowitz Center for Health Literacy Associate Professor in the Family Science Department, and a State Family Policy Specialist for the Maryland Cooperative Extension. Thank you to Dr. Braun for her time and expertise.