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https://www.goodrx.com/how-goodrx-works (mirror) claims that:

The #1 reason Americans don't take their medications as prescribed: cost.

Is that true?

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Not sure this is good enough for an answer but, generally no.

Patient Education, Side effects, and other concerns usually trump costs. I can't find a nice pie chart to lay out this fact for you but take a look at https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3068890/

It lists some of the largest concerns with patients continuing to take medications as prescribed. Their most mentioned one is Patient Education (medical literacy). But they also list problems with the medical system in general, lack of patient engagement, and the fact that if you have to take a pill forever you're just going to forget from time to time.

To @tim's point. This data doesn't really cover the question directly. It only shows that there are other concerns in some cases. I will also add an excerpt from http://blog.ensocare.com/trend-reports/medication-noncompliance-why-wont-patients-take-their-meds

The number of Americans not taking their medications properly is staggering. According to the National Council for Patient Information and Education, about half of the 2 billion prescriptions filled each year in the U.S. are not filled or taken correctly:

  • 12 percent don’t fill their prescription at all
  • 12 percent don’t take medication at all after they fill the prescription
  • 29 percent stop taking their medication before it runs out
  • 22 percent take less of the medication than is prescribed on the label

While not a direct answer is shows that of the people not filling or taking their prescriptions correctly 63% have already paid for the prescription. It also shows that 29% (the number one spot on this list) stop taking their medication before the prescription runs out.

However you should note that it doesn't say why 12% of the prescriptions are never filled.

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    There's also the fact that (at least in my personal experience) doctors seldom have the same priorities as patients. Take for instance high blood pressure: usually symptomless, but some common medications to reduce it have unpleasant side effects. The doctor (who does not experience those side effects) may think them a reasonable tradeoff for treating the condition; the patient thinks otherwise.
    – jamesqf
    Commented Jan 31, 2017 at 21:05
  • I don't think that this answers the question. The paper names a number of reasons, but doesn't actually rank them. It also mentions cost (but doesn't say if it is a primary reason or a neglectable reason), which you omitted. If the paper does state something related to the question which I overlook, it would be good to include it as quote in your answer. Note also that the paper is about chronic illnesses (specifically cardiovascular disease), while the question isn't focused specifically on that.
    – tim
    Commented Jan 31, 2017 at 21:35
  • The paper also states that one of its main goals is to "[present] various strategies and resources for improving medication adherence". Focusing on the cost aspect doesn't seem practical here, which may be why the paper doesn't focus so much on costs, but it does mention that "Consideration of patients' economic status is of paramount importance"
    – tim
    Commented Jan 31, 2017 at 21:40
  • I know it's not a great answer. But I can not find a document that spells out why patients don't take their medicine, that doesn't end up being some kind of sales material. I will add another fact to the answer but I don't think it will help much.
    – coteyr
    Commented Jan 31, 2017 at 21:48

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