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Taking a prescription every day sounds simple—until cost, side effects, an unpredictable schedule, or complicated instructions get in the way. Medication adherence, which means taking medications as agreed upon with a healthcare provider, remains a significant healthcare challenge in the United States. According to the Centers for Disease Control and Prevention (CDC), approximately one in five new prescriptions is never filled, and about half of filled prescriptions are taken incorrectly, due to timing, dosage, frequency, or treatment duration.
If this is you, you’re not alone. Fortunately, many of the most common barriers to prescription adherence can be addressed. Read on to learn more about why medication adherence matters and how it can be achieved.
What Is Medication Adherence?
The U.S. Food and Drug Administration (FDA) defines medication adherence as the extent to which people take medication as prescribed by a healthcare provider.
Tasks that fall under the category of medication adherence include:
• Filling the original prescription
• Remembering to take the medication
• Taking the correct amount
• Taking it at the correct time
• Understanding and following instructions about food (like coffee), interactions, etc.
• Obtaining refills before the medication runs out
• Continuing treatment for the recommended length of time
You may also hear the term “medication compliance.” Although the two terms are sometimes used interchangeably, “adherence” is generally preferred. “Compliance” is considered old-fashioned as it can sound as though patients are expected to follow orders without participating in decisions. Adherence recognizes that successful treatment should involve communication and agreement between you and your healthcare professional.
Medication adherence matters because a treatment won’t work as intended when it is not used correctly. According to the CDC, adherence to prescribed medications is associated with better outcomes in chronic disease management as well as reduced mortality. Medication nonadherence, by contrast, is associated with poorer health outcomes, increased illness and mortality, more hospital admissions, and greater healthcare spending.
It truly benefits everyone—but especially patients—when medications are taken as intended.
The right solution to medication adherence depends on the reason a person is struggling. A reminder may help someone who forgets a morning dose, but it will not help someone who cannot afford the prescription. Effective prescription medication management begins by identifying the actual barrier.
10 Reasons Americans Skip Their Prescriptions—and How to Fix Them
There are more reasons Americans skip their medications than you might think. Here are 10 of them.
1. Prescription Costs Are Too High
Cost is one of the most significant reasons Americans skip prescriptions. Even people with health insurance may face high deductibles, copays, coinsurance, coverage restrictions, or medications that are not included on their plan’s formulary. People may need an even broader plan for staying on their medications after losing health insurance.
In a 2021 national survey, 8.2% of U.S. adults ages 18–64 who had used prescription medication reported not taking it as prescribed because of cost. Cost-related medication nonadherence can include delaying a refill, taking less medication than prescribed, splitting doses without medical approval, or leaving a prescription unfilled.
How to address it:
Ask the prescriber or pharmacist whether an FDA-approved generic alternative is available. The FDA explains that approved generic drugs contain the same active ingredients and must meet the same scientific quality standards as their brand-name counterparts. Generics frequently cost less because manufacturers do not have to repeat the extensive clinical studies conducted for the original brand-name drug. (Learn about the differences between generic and brand name drugs here.)
You can also:
• Compare prices at different pharmacies.
• Ask whether a 90-day supply would cost less.
• Review your insurer’s formulary.
• Ask whether another covered drug could treat the same condition.
• Investigate manufacturer assistance programs.
• Look for state or nonprofit prescription assistance programs.
• Find lower-cost prescription options from licensed Canadian pharmacies.
People with Medicare and limited income or resources may qualify for Medicare’s Extra Help program, which helps with Part D premiums, deductibles, and prescription expenses. More ways to lower prescription costs safely can be found here.
Never reduce doses, split tablets, or stop medication without talking to a pharmacist or prescriber. Some tablets should not be divided, and altering a dosing schedule can make treatments less effective or even unsafe.
2. Medication Is Forgotten
Forgetfulness is one of the most familiar causes of medication nonadherence. Busy schedules, travel, shift work, caregiving responsibilities, and changes in routine can all make a dose easier to miss.
The problem becomes more complicated if you take several medications or need to take medications at different times.
How to address it:
Medication reminders work best when they fit naturally into daily life. Options include:
• Setting alarms on a phone or watch
• Using a weekly pill organizer
• Using a medication tracking app
• Keeping a checklist or medication calendar
• Linking a dose to an established routine, such as brushing your teeth
• Asking a trusted caregiver to provide reminders
Keep in mind, you still need to keep medicines in a safe, appropriate location and follow all storage instructions. Do not leave medication somewhere hot, humid, accessible to children, or accessible to pets simply because that location is easier to see.
Also, a pill organizer may not be appropriate for every drug. Some medications need to remain in their original packaging to protect them from moisture, light, or accidental misuse. A pharmacist can explain how each prescription should be stored.
3. Medication Side Effects Are Burdensome
Nausea, fatigue, dizziness, digestive problems, headaches, sexual side effects, sleep changes, and other unwanted side effects may lead a person to skip doses or stop treatment. It’s important to note that many side effects do diminish over time, however.
How to address it:
Always talk to the prescriber or pharmacist rather than stopping the medication on your own. They will be able to guide your next steps appropriately.
Depending on the drug and your health, a healthcare provider may be able to do one or more of the following to alleviate side effects:
• Change the time of day the medication is taken.
• Recommend taking it with or without food.
• Adjust the dose.
• Treat or monitor the side effect.
• Switch to another medication.
• Determine whether the side effect has another cause.
Never assume that suddenly stopping a medication is harmless. Some drugs can cause withdrawal symptoms, rebound symptoms, or a worsening of the underlying condition when discontinued abruptly. Ask how to stop safely if a change is needed.
Seek urgent medical help for symptoms of a potentially serious reaction, such as trouble breathing, swelling of the face or throat, fainting, or severe or rapidly worsening symptoms. Read the medication leaflet for a list of all the possible side effects that require immediate intervention.
4. Starting to Feel Better
Feeling better is great! It’s the point of taking medication, but some people stop treatment once symptoms begin to disappear. These people conclude that the medicine has finished its job.
However, feeling better does not always mean that treatment is no longer needed. The medication may be controlling the condition, preventing recurrence, or reducing risks that cannot be felt.
How to address it:
Before stopping a medication, ask the prescriber:
• How long am I expected to take this medication?
• How will we decide whether I still need it?
• Does it need to be reduced gradually?
• What could happen if I stop now?
Do not automatically stop a medication because symptoms have improved. Some medications (like antibiotics) require a full course to be effective, and you may feel better before the course is complete. At the same time, not every prescription is intended to be taken indefinitely. Follow your individualized treatment plan and ask for a medication review when the expected duration is unclear.
This is particularly important with medications used for chronic conditions, such as high blood pressure, because the condition may remain present even if you’re feeling better.
5. Not Understanding the Instructions
Prescription labels can be confusing. Directions such as “twice daily,” “as needed,” “on an empty stomach,” or “avoid taking with certain products” may be interpreted differently by different people.
Directions about dosage, timing, food, and gradual dose changes can be particularly important with medications such as antidepressants and antipsychotics.
Health literacy, language barriers, small print, medical terminology, and multiple dosing schedules can further complicate taking medications as prescribed.
How to address it:
Never leave the pharmacy without a complete understanding of how you are to take the medication. Remember, the pharmacist works for you.
Ask the pharmacist to explain:
• What the medication is for
• Exactly how much to take
• What times to take it
• Whether it should be taken with food
• What should be avoided
• What side effects are serious, and what to do if they occur
• What to do after a missed dose
Use the “teach-back” method: repeat the instructions in your own words and ask whether you understood them correctly.
Request written directions in plain language and, when needed, ask whether translated instructions, large-print labels, easy-open packaging, or accessible communication options are available.
6. Fearing Long-Term Medication Use
Some patients worry that they will become dependent on medication, experience physical damage, develop serious side effects, or need progressively higher doses. Online misinformation and frightening personal stories can intensify these concerns.
Questions about long-term treatment are reasonable. You’re not alone if you have them. However, if fear leads you to stop medication without obtaining reliable, individualized information, that is a problem.
How to address it:
Bring your specific concerns to the prescriber or pharmacist. Leave no question unasked. Useful questions include:
• What are the known long-term risks?
• How likely are those risks for me?
• What monitoring will I need?
• What are the risks of leaving my condition untreated?
• Are there non-medication options or alternative medications available?
• When will we reassess whether I still need this?
You can also consult reliable sources of medication information like the FDA, the National Library of Medicine’s MedlinePlus, and information supplied by licensed healthcare professionals.
Treatment decisions should balance the potential benefits and risks of the medication with the risks of the untreated condition.
7. Needing a Complex Medication Regimen
Managing several prescriptions can become a job of its own. One medication may be taken in the morning, another with meals, another every other day, and another at bedtime. This is especially difficult for seniors, people with several chronic conditions, and patients who see multiple healthcare providers.
Research shows that medication adherence can decrease as the complexity of the treatment regimen increases.
How to address it:
If you’re finding it hard to keep up with your own treatment regimen, ask for a comprehensive medication review. A prescriber or pharmacist may be able to:
• Eliminate unnecessary or duplicate medications.
• Simplify the dosing schedule.
• Use a combination product when medically appropriate.
• Change a medication taken frequently to a longer-acting option taken less frequently.
• Align refill dates.
• Arrange blister packaging or another adherence aid.
• Automatically refill ongoing prescriptions.
Your healthcare provider and pharmacist may need to work together for the best solution for you.
8. Mental Health or Cognitive Challenges Getting in the Way
Depression can make even basic daily tasks feel overwhelming. Anxiety can increase the fear of adverse effects. Attention problems, brain fog, dementia, or memory impairment can make it difficult to remember whether a dose was taken.
Mental health and cognitive symptoms may also lower motivation or make attending appointments and requesting refills more difficult. Remember, though, these are health-related barriers—not personal failures.
How to address it:
Useful supports may include:
• Treating the underlying mental health or cognitive condition
• Using alarms or a medication app
• Using pharmacy-prepared adherence packaging (such as blister packs)
• Involving a trusted caregiver
• Placing a medication chart in a visible but private location
• Scheduling regular pharmacist or provider check-ins
Your independence is still of utmost importance, though. Others can help with medication adherence without completely taking over. If you are repeatedly missing doses, accidentally taking extra medication, or becoming confused about prescriptions, a prompt medical and medication review is important.
9. Having Difficulty Getting Refills
A person may fully intend to continue treatment but encounter transportation problems, appointment delays, pharmacy closures, prescription-expiration issues, drug shortages, insurance authorization requirement difficulties, or a busy work schedule.
You might find that running out of medication is a system or access problem rather than a deliberate choice.
How to address it:
Consider:
• Automatic refills
• Text or email refill reminders either by the pharmacy or through a phone app
• Requesting refills several days before medication runs out
• 90-day supplies when permitted
• Medication synchronization
• Delivery or mail-order services offered through the pharmacy or insurance plan
• Scheduling required follow-up visits in advance
Automatic refills are not appropriate for every prescription, especially when the dose changes frequently or the medication requires regular monitoring. If you have mail-order prescriptions, confirm the order before it ships and periodically review which prescriptions remain active.
10. Feeling They Don’t Need the Medication
High blood pressure, high cholesterol, osteoporosis, and early type 2 diabetes may cause few noticeable symptoms. When a person feels fine, the medication may seem unnecessary—particularly if taking it creates costs or side effects.
However, some treatments are intended to reduce future risks rather than make you feel different today.
For example, the CDC notes that nonadherence to blood-pressure medication can contribute to uncontrolled hypertension; this, in turn, raises the risk of cardiovascular events. That’s an outcome that no one wants.
How to address it:
Ask the prescriber to explain the medication’s goal in concrete terms:
• Is it treating a symptom?
• Is it changing a laboratory result?
• Is it slowing disease progression?
• Is it reducing the risk of a future complication?
• How will we know whether it is working?
Regular follow-up appointments, blood tests, home monitoring, understandable explanations, and, in some cases, wearable health data can make the benefit feel less abstract.
What Are the Risks of Poor Medication Adherence?
The consequences of medication nonadherence depend on the medication, dose, condition, and length of the interruption. One late dose does not carry the same risks as repeatedly skipping treatment or abruptly stopping your medication.
Possible consequences include:
• Reduced treatment effectiveness
• Return or worsening of symptoms
• Poorer control of chronic disease
• Avoidable complications
• Treatment failure
• Hospital or emergency department visits
• Additional medical expenses
The CDC reports that medication nonadherence is associated with suboptimal health outcomes, increased illness, hospital admissions, and increased healthcare costs.
The purpose of discussing these risks is not to blame or frighten you. Medication nonadherence is rarely solved through criticism. It is more useful to consider, “What is making taking this treatment difficult, and what would make it easier?”
Practical Tips for Improving Medication Adherence
Use this quick prescription medication management checklist for easier treatment adherence:
* Keep an up-to-date list of prescriptions, over-the-counter medications, vitamins, and supplements.
* Use a pill organizer when a pharmacist confirms that it is appropriate.
* Set daily medication reminders on a phone, watch, clock, or app.
* Connect doses with a consistent daily routine. (For example, always take your medication when you brush your teeth, and put your medication container beside the toothpaste to remind you, if appropriate.)
* Request refills before your medication runs out.
* Ask the pharmacist to explain anything unclear.
* Tell a healthcare provider about side effects instead of silently stopping treatment.
* Ask about lower-cost generics, covered alternatives, and assistance programs.
* Use one pharmacy when possible so a pharmacist can more easily identify potential medication interactions or duplication.
* Review all medications at least annually and after hospitalizations or major health changes.
FAQs: Medication Adherence
What is medication adherence?
Medication adherence means filling prescriptions and taking medication according to the treatment plan agreed upon with the healthcare provider. This includes taking the correct dose at the correct time and continuing it for the recommended duration.
Why do Americans skip their prescriptions?
Common reasons include prescription costs, forgetfulness, side effects, confusing directions, complicated schedules, mental health symptoms, refill barriers, concerns about long-term use, and not feeling an immediate benefit.
A person may experience more than one barrier at the same time. For example, someone may dislike a side effect and also struggle to afford the refill.
How can I remember to take my medication?
Set an alarm, use an appropriate pill organizer, create a written schedule, or connect the dose to a daily habit. Medication apps and automated pharmacy reminders may also help. Choose a method that matches your routine rather than creating an entirely new one.
What happens if I miss a dose?
The correct response depends on the medication. Do not automatically take two doses.
Check the prescription information or contact a pharmacist for drug-specific advice. Although instructions for many medications say to take a missed dose when remembered unless it is nearly time for the next one, this rule does not apply universally. The safest choice is to follow the directions supplied for that specific medication.
The National Library of Medicine’s medication database provides drug-specific information, including missed-dose instructions for many prescriptions.
How can I lower prescription costs?
If you are struggling with high prescription drug prices, you may need to compare available, lawful purchasing and coverage options, including understanding why some Americans buy prescriptions from Canadian pharmacies. Ask about generic alternatives, compare pharmacy prices, review insurance coverage, request a 90-day supply when appropriate, and ask whether another medication on the plan’s formulary could provide similar benefits.
People with Medicare should check whether they qualify for Extra Help with Medicare drug costs. Other patients may qualify for Medicaid, state assistance, nonprofit support, or a manufacturer’s patient assistance program.
The Bottom Line on Taking Medications as Prescribed
Medication adherence is one of the most important factors influencing whether a treatment succeeds, but it is not simply a matter of remembering to swallow a pill. Cost, side effects, confusing instructions, mental health symptoms, refill problems, and complex schedules can all make prescription adherence difficult.
Most barriers can be addressed more effectively when you discuss them openly. A pharmacist may be able to clarify instructions, identify lower-cost options, coordinate refills, or suggest an adherence tool. A prescriber may be able to simplify the regimen, adjust a dose, address side effects, or recommend another treatment.
Do not stop, reduce, or change a prescription without professional guidance. When taking medications as prescribed becomes difficult, the best next step is not to hide the problem—it is to ask for a plan that is safer, clearer, more affordable, and realistic for everyday life.
Sources
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2. Center For Drug Evaluation And Research. (2026, June 8). Generic drugs: questions & answers. U.S. Food And Drug Administration. Retrieved June 15, 2026, from https://www.fda.gov/drugs/generic-drugs/generic-drugs-questions-answers
3. Kvarnström, K., Westerholm, A., Airaksinen, M., & Liira, H. (2021). Factors Contributing to Medication Adherence in Patients with a Chronic Condition: A Scoping Review of Qualitative Research. Pharmaceutics, 13(7), 1100. https://doi.org/10.3390/pharmaceutics13071100
4. Neiman, A. B., Ruppar, T., Ho, M., et al. (2017). CDC Grand Rounds: Improving Medication Adherence for Chronic Disease Management — Innovations and opportunities. MMWR Morbidity and Mortality Weekly Report, 66(45), 1248–1251. https://doi.org/10.15585/mmwr.mm6645a2
5. Mykyta, L., & Cohen, R. (2025). Characteristics of Adults Aged 18–64 Who Did Not Take Medication as Prescribed to Reduce Costs: United States, 2021. In Centers for Disease Control and Prevention (CDC) Stacks (NCHS Data Brief No. 410). Retrieved June 15, 2026, from https://stacks.cdc.gov/view/cdc/127680
6. US Food and Drug Administration. (2015, November 10). Taking Medications Correctly -- Medication Adherence (October 2015) [Video]. US Food and Drug Administration. Retrieved June 15, 2026, from https://www.fda.gov/drugs/fda-drug-info-rounds-video/medication-adherence-october-2015
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