Medication costs are skyrocketing, thanks to increasing prescription drug costs and a growing number of people taking drugs for chronic conditions. People with multiple prescriptions, lower incomes, or insurance that doesn’t cover prescription are especially crunched. Shirking on prescriptions can have disastrous consequences, but doctors can help their patients with costs if they know it’s a problem. However, doctors and patients may not be talking about cost as often as they should, according to new research from the University of Michigan.

What they wanted to know: Do patients who don’t fill their prescriptions or take less of their medications because of cost talk to their doctors about it?

What they did: The researchers used a pool of people recruited by scientists at Stanford University who were given a year of free WebTV and Internet access in exchange for completing several Internet surveys each month and giving various researchers access to some of their personal information. From that pool, the researchers identified people older than 55 taking medications for chronic illnesses and asked them if they had taken fewer or none of their medications over the past year because the prescriptions cost too much. Of those who had, 660 responded to a second questionnaire, which asked them more specific questions about whether they had talked to their doctors about prescription costs and how their doctors responded.

What they found: Just over a third of the people in the survey had never talked to a doctor or nurse about problems they had paying for their medications. More than half of the people who had not brought up cost said they didn’t because no one had asked them or they didn’t think it would be of any help. Forty-six percent said they were too embarrassed to initiate the conversation, and about the same number said they didn’t think the issue was important enough. For those people who did talk to their doctors, the doctors gave their patients free samples of medication in 9 out 10 instances, but only 69 percent changed one or more of their patients’ prescriptions to a less expensive medication or generic brand. Even fewer, 30 percent, said their doctors talked to them about programs that help people pay for their medications.

What it means to you: Cutting back on medications without first consulting either a doctor or nurse can have serious consequences. Patients who did talk with their doctor about costs reported that doctors were usually helpful and tried to reduce costs. Doctors should ask if drug costs are a problem, but because they are usually busy, may not know what other medications a patient has been prescribed, or don’t realize how expensive the medications are, patients should not be shy about bringing the topic up.

Caveats: The survey was done over the Internet, which typically attracts more white, high income, and highly educated people than are in the general population. So, having more of these people respond could have skewed the results-but you’d expect poorer people to have even more trouble paying the cost of drugs, and some of the results suggested they were less likely to talk to their doctors as well.