The cost of prescription drugs is skyrocketing, and millions of Americans each day make potentially dangerous decisions just to afford the medicines they need. They put themselves at risk by skimping on food and clothing budgets, stretching critical drug dosages, and taking on crippling debt to pay for their prescriptions. Consumers split pills, fail to take drugs as prescribed, take expired medications, or share prescriptions in order to save money. Or they don’t take them at all.

Meanwhile, pharmaceutical companies pour millions of dollars into aggressive marketing campaigns designed to make doctors and consumers choose expensive, brand name drugs, even when less expensive, generic alternatives are available. They are engaged in fierce price-fixing campaigns designed to cripple the consumer and enrich themselves. As drug manufacturers pad their profit margins at the expense of patients’ safety, they undermine the very purpose of their industry — to improve and extend people’s lives.

And politicians are doing nothing to stop it. Lawmakers continue to prohibit Americans from purchasing safe, affordable drugs abroad, catering to the lobbyists of the pharmaceutical industry.

The United States spent $2.5 trillion on health care in 2009, which amounts to $8,086 per person — which an American could use to make a car payment for two years. Health care spending equals 17.6 percent of the nation’s gross domestic product, or the total worth of all goods and services produced in the country, according to the Centers for Medicare & Medicaid Services.1 That means money spent on health care is eating up almost 20 percent of the entire U.S. economy.

It wasn’t always this way. Americans spent $249.9 billion on prescription drugs in 2009, more than double what they paid ten years before, and nearly 12 times what Americans were paying two decades earlier. In 1999, Americans spent $104.7 billion on prescription drugs, and in 1980, they spent $12 billion.

And much of the money spent is coming directly from consumers’ pockets. More than 20 percent of the total spent on prescription drugs in 2009, or $53 billion, was paid completely out-of-pocket by Americans, without the help of health insurance, Medicare, Medicaid or other health care assistance programs.

American seniors are especially hard-hit. A 2002 study by HealthAffairs, funded by the Commonwealth Fund and the Henry J. Kaiser Family Foundation, found that nearly one-quarter of seniors, or 23 percent, spent more than $100 per month for prescription medicines. For seniors without prescription drug coverage, 43 percent spent more than $100 per month.2

No wonder Americans are feeling frustrated, powerless, and overwhelmed. How did this happen?

A major reason that prescription drugs are such a huge drain on Americans’ pocketbooks is that prescription drug use has gone up. From 1998 to 2008, the percentage of Americans who took at least one prescription drug within the previous month increased from 44 to 48 percent, according to the Centers for Disease Control and Prevention.3 The number of Americans who used two or more prescription drugs increased from 25 to 31 percent. And the number of people who used five or more drugs increased from 6 to 11 percent.

Another reason prescription drugs costs have risen is that massive pharmaceutical companies are engaging in aggressive price fixing or price inflations campaigns, keeping affordable drugs out of consumers’ reach.

Drug companies give doctors perks for encouraging patients to buy more expensive, brand name drugs and also appeal directly to consumers to pressure them to buy more expensive drugs, using money that could be used to lower drug prices to justify their high prices.

Pharmaceutical companies also use pay-to-delay tactics to keep generic versions of popular drugs off the market.

In response, Americans are forced to make risky decisions to cut costs.

In a 2010 survey of adult prescription drug takers, 39 percent reported taking some action to reduce prescription drug costs in the previous year, according to Consumer Reports National Research Center.4 Some of these actions were potentially dangerous.

In the survey, 27 percent did not take a drug as prescribed — 16 percent did not get a prescription filled, 12 percent took an expired medication and 4 percent shared a prescription with someone in order to save money.

According to a survey done by the Kaiser Family Foundation, more than one-third of patients, or 37 percent, asked their doctor or pharmacist if there was a less expensive generic version of their drug available. Some do not know to ask. Drug manufacturers push doctors and consumers to choose brand name drugs even when there is no evidence that the brand name drug is more beneficial.

Some consumers avoid going to the doctor altogether out of fear of having to pay for tests, copays, prescription drugs, or missed work. These actions can aggravate illness.

Others are going into debt — taking out loans or opening credit cards — in order to buy prescription drugs.

Some turn away from the medicine prescribed and opt for an over-the-counter version.

Some are simply going without the drugs they need.

According to a HealthAffairs study, seniors without drug coverage were two to three times more likely to forgo taking medicine than their counterparts who had coverage. One-quarter of seniors without coverage said they did not fill prescriptions or skipped doses to stretch out their medicines in the previous year.

Approximately 10 percent of seniors with prescription drug coverage reported going without medicine.

Twenty percent of seniors without prescription drug coverage said they spent less on basic necessities, such as food and clothing, to pay for prescription drugs. Ten percent of those with coverage said they went without basic necessities to pay for medicines.

Among seniors with low incomes, 41 percent with no drug coverage reported that they simply did not fill their prescriptions due to costs, and 36 percent said they skipped doses to make medications last longer. For low-income seniors with coverage, 19 percent failed to fill prescriptions and 21 percent skipped doses. More than one-third of poor seniors without coverage, or 38 percent, said they spent less on basic necessities so they could pay for their medicines.

Seniors with chronic medical conditions who lacked drug coverage reported rates of forgone medications two to three times higher than those of their counterparts with drug coverage. Among those with congestive heart failure, diabetes, or hypertension—each of which require adherence to a strict medication regimen for disease management—more than a fourth of those without coverage did not fill at least one prescription in the past year because of the cost, more than one-tenth did not fill three or more prescriptions, and approximately one-third skipped doses to make prescriptions last longer

Among those with three or more chronic conditions and without drug coverage, approximately one-third reported not filling prescriptions because of cost—17 percent said that they did this three or more times during the year—and 36 percent skipped doses to make their medication last longer. Nearly one-fifth of covered seniors with multiple chronic conditions reported these actions.

Americans concerned about the high costs of prescription drugs can encourage their congressmen to take action to:

• Visit the CALL TO ACTION page on PayingthePrice.org. Sign the petition and send a letter to your congressman to show your support for affordable prescription drugs.

• Increase the availability of generic drugs.

• Speed up the approval process for generic drugs at the Food and Drug Administration.

• Close loopholes that allow drug manufacturers to hold a patent for seven years before a generic drug can be introduced, and agreements between brand name drug makers and generic drug makers that essentially create a ‘brand name’ generic drug.

• Restrict marketing by drug companies to doctors and consumers.

• Make it legal to import safe drugs from abroad, including licensed Canadian pharmacies.

PayingthePrice.org will give you the knowledge to understand the prescription drug cost crisis and the tools to spread the word and help make a change.