45% of US consumers aged under 65 who do not have a prescription drug benefit are now failing to fill their prescriptions because of the cost, compared with just 27% a year ago, says new research.

The US economy's negative effects have been most profoundly felt by people under the age of 65 who do not have insurance for medications, according to the annual prescription drug poll conducted by advocacy organisation Consumer Reports. 

Over 81% of this age group told the poll that over the last year, they have done one of the following:
- declined a medical test because of cost - 62% this year, up 29 percentage points from 2011;
- skipped filling a prescription because of cost - 45%, up 19 percentage points;
- put off a doctor's visit to save money - 63%, compared with 47% last year; or

- skipped a medical procedure because of cost - 51% this year, up from 39% in 2011.

This age group is also cutting back on spending elsewhere to be able to pay for their medicines, whether or not they have a prescription drug benefit. 28% of the under-65s with drug insurance and 58% of those without say they are spending less on entertainment and dining, while 21% of those with drug cover and 46% of those without are spending less on groceries, and 15% of over-65s with a drug benefit and 22% without report that they are usng their credit cards more.

"When it comes to prescription drugs, consumers are spending on average $63 out-of-pocket every month, which can easily swallow up a big portion of the family budget - it's even worse for those without insurance for medicines, who pay upwards of $91 a month for their prescriptions," noted Lisa Gill, editor, prescription drugs at Consumer Reports.

"We recommend several cost-cutting strategies, such as the $4 a month generic programmes at the big-box and chain pharmacies, and if you aren't already taking a generic, talk to your doctor about switching," Ms Gill advised.

Other strategies for reducing costs include pill-splitting where appropriate, and even substituting over-the-counter (OTC) drugs for prescription medicines, the group suggests.

In addition to foregoing medical care, consumers are reluctant to confide in the professionals who are in the best position to help them cut costs, the poll also finds. 68% of those questioned said they were uncomfortable discussing personal financial difficulties with their pharmacist, and 47% felt the same way about their physician, a finding which Consumer Reports describes as "a very serious red flag."

"Patients need to speak up, but doctors have a role too," said Dr John Santa, director of the Consumer Reports Health Ratings Center. 

"An important part of a physician's professional obligations includes assistance navigating stressful financial times - especially when part of the stress is related to the health care a physician orders or provides. For most physicians, their goal is to care for the whole patient, not just the portion carrying the wallet,” he added.