Sept. 13, 2012 -- Americans are scrimping to pay for their prescription medications, and some are playing dangerous games with their health as a result.

More than 80% of Americans who don't have prescription drug coverage are not filling their prescriptions, skipping medical tests, passing on doctor's appointments because of cost, or cutting corners elsewhere, a new Consumer Reports poll shows.

Nearly half of the adults polled did not fill a prescription because of cost in the past year, compared with 27% last year. This is the fourth year that Consumer Reports conducted the poll, and things seem to be getting worse.

"The jump from one year to the next was massive, bordering on a crisis," says Lisa Gill. She is the editor of prescription drugs for Consumer Reports in Yonkers, N.Y.

The telephone poll showed that 46% of U.S. adults take prescriptions drugs. The average number of drugs is 4.1. And it's not just the elderly who take multiple prescriptions. One quarter of people aged 18 to 39 take two prescription medications, the poll showed.

According to the poll, because of cost:

• 62% of people declined a medical test.
• 45% did not fill a prescription.
• 63% delayed a doctor's appointment.
• 51% skipped a medical procedure.

Others spent less on groceries, their family, and/or put off paying bills to pay for their medications.

These penny-pinching moves may have serious health consequences, Gill says. People with chronic conditions such as high blood pressure or asthma who need to take several medications may be putting themselves at risk by skimping on their drugs, she says. Untreated high blood pressure is a major risk factor for stroke and heart attack.

But there are certain things people can do to keep costs in check without sacrificing their health, she says.

For starters, always ask the prescribing doctor about cost and whether there is a generic or an equivalent medication with a generic version, Gill says. Your pharmacist can also assist you with this type of information. Generic drugs cost less and work as well as the brand name drug. In most states, pharmacists must substitute generic drugs for brand name drugs unless the prescribing doctor tells them to do otherwise.

All retail drug stores have a discount generic drug program. "This is a good place to start, and you don't need insurance to participate," Gill says. Some programs are free and others have minimal costs.

Manufacturers also have assistance programs to help offset drug costs. "Read the fine print," she says. "Many expire or have limits, so if the medication is something you will be taking for years, this may only be a short-term solution."

Harry Schiavi heads a New York City-based consulting firm that deals with reimbursement of prescription drugs. As such, these are issues he grapples with daily. 

Don't sell the drug companies short, he says. "There may be an awareness issue with regard to the amount of assistance that manufacturers are providing to patients for their pharmacy costs," he says. "As insurance co-pays are going up for insured consumers, some pharmaceutical companies are increasing the eligibility levels for patient out-of-pocket assistance." 

Randy Wexler, MD, says the new poll findings mirror what he sees and hears in his practice. He is an associate professor of family medicine and the vice chair of clinical affairs at Ohio State Wexner Medical Center in Columbus.

"I had one patient who would not see a specialist due to cost, even though a test suggested they had cancer," he says. And "every day someone asks if they need to take all of their prescribed medications due to cost."

This is not just affecting senior citizens. "This is more common in the elderly, but we are seeing it more and more in younger individuals because the cost of health care has gotten so high," he says.

Wexler has a social worker on staff that spends the biggest chunk of her day price-shopping for patients. "We know that the lower the drug costs, the higher the compliance," he says. "There are times we have to say, 'This is your condition, this is the money you have to work with, this is what can be forgone.'"

Some people may split pills to save money. This is not always OK. Talk to your doctor or pharmacist before splitting pills," he says. And "it's never OK to take medication prescribed to someone else."