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Imagine if 22% of fields that need fertilizer from Agrium (NYSE: AGU  ) never got it. Or 22% of cars were just abandoned by their owners because they didn't bother filling up their tanks with product from ExxonMobil (NYSE: XOM  ) or Chevron (NYSE: CVX  ) . Investors would be frothing at the mouth at the potential for increased sales.

That's the situation that drugmakers are in. An article in this month's Journal of General Internal Medicine found that 22% of prescriptions are never filled. Imagine if every drugmaker was suddenly able to realize those sales, which were apparently medically necessary since a doctor wrote the prescriptions. There'd be an instant 28% increase in revenue -- maybe higher if the drugs that aren't filled are at the higher end of the cost scale.

And that might be the rub
The people in this study had insurance -- that's how they tracked the prescriptions -- but in most plans there's still a difference in the level of co-payment for generic drugs and branded drugs. At a cost of double or more their generic counterparts, branded drugs may be out of reach for some patients.

That's one of the reasons pharmaceutical companies have struck deals with health insurers to lower the co-pay in exchange for discounting the price the insurer pays for their branded drugs. The drugmakers make less money per prescription, but the lower co-pay may encourage patients to refill their medications month after month.

I imagine the number of abandoned prescriptions is much higher when you include the uninsured. That's part of the reason that the pharmaceutical companies were so quick to strike a deal to give up some of their profits to help low-income seniors in the Medicare donut hole. They tied the agreement to the passage of the entire health-reform package, which should increase the number of insured patients who are able to afford medications.

Of course, health-care reform is in limbo right now, but if anything does pass, the number of people the bill can get off the uninsured rolls is the key number that drug investors should look for.

A little education could go a long way
The breakdown of drugs that didn't get picked up could give clues about which drugs might benefit if drugmakers could decrease the abandonment rate. Not surprisingly, prescriptions for drugs that treat children were picked up at a higher-than-average level. Adults apparently aren't as likely to gamble with their children's health as their own.

Pain medications was the highest class of new prescriptions that weren't picked up -- a whopping 55.2% of the prescriptions. Drug companies may have a hard time capturing those patients though -- I imagine a lot of them were for patients who started to feel better and decided they didn't need the drugs after all.

But there were a few other classes where drugmakers might have better luck. New prescriptions for hypertension medications weren't picked up 28.4% of the time, cholesterol drugs like Pfizer's (NYSE: PFE  ) Lipitor or AstraZeneca's (NYSE: AZN  ) Crestor weren't picked up 28.2% of the time, and diabetes drugs like Merck's (NYSE: MRK  ) Januvia or GlaxoSmithKline's (NYSE: GSK  ) Avandia had a whopping 31.4% abandonment rate. For these relatively long-term illnesses, patients aren't likely to feel sick when given the prescription and may be more likely to put off filling their medications.

It might be time for drug companies to start launching commercials encouraging patients to pick up their drugs rather than the current mantra encouraging you to "talk to your doctor." Based on this data, the return on investment could be fairly high.

Tim Hanson has a prescription to save your portfolio. Don't forget to pick it up.

Pfizer is a recommendation of the Inside Value newsletter. The Inside Value team scours high and low to bring you the best value stocks available. Check it out for free with a 30-day trial.

Fool contributor Brian Orelli, Ph.D., doesn't own shares of any company mentioned in this article. The Fool owns shares of Glaxo. Read the Fool's disclosure policy twice, and call us in the morning.

Read/Post Comments (5) | Recommend This Article (4)

Comments from our Foolish Readers

Help us keep this a respectfully Foolish area! This is a place for our readers to discuss, debate, and learn more about the Foolish investing topic you read about above. Help us keep it clean and safe. If you believe a comment is abusive or otherwise violates our Fool's Rules, please report it via the Report this Comment Report this Comment icon found on every comment.

  • Report this Comment On February 26, 2010, at 7:31 AM, JaneJohns wrote:

    It's not always the cost. I've gone to doctors who love to write prescriptions: I go home and do a little research before filling them to make sure I'm not just going to acquire a new set of problems. For instance, I was recently prescribed Crestor even though my cholesterol levels are fine, just because I have asthma. After doing the research I found that I could have a very slight reduction in future heart issues (although I have no real reason to believe I'll have any) but I'd also have an increased chance of diabetes. So instead of filling the prescription, I'm shopping for a new doctor.

    Also, when my kids' pediatrician writes prescriptions for prophylactic antibiotics, I always ask if I can just hold onto the prescription and watch carefully for signs of infection. I've NEVER had to fill any.

    On the other hand, anything that brings down the costs is great!

  • Report this Comment On February 26, 2010, at 11:41 AM, cdhone wrote:

    Here's your problem - "which were apparently medically necessary since a doctor wrote the prescriptions".

    Most prescriptions are anything but a medical necessity. In fact many of the scrips are written because Joe Consumer asks about a drug he sees an ad for on tv.

    If you think all prescriptions are necessities I suggest you lay off some of your meds.

  • Report this Comment On February 26, 2010, at 11:41 AM, cdhone wrote:

    Here's your problem - "which were apparently medically necessary since a doctor wrote the prescriptions".

    Most prescriptions are anything but a medical necessity. In fact many of the scrips are written because Joe Consumer asks about a drug he sees in ad on tv.

    If you think all prescriptions are necessities I suggest you lay off some of your meds.

  • Report this Comment On February 26, 2010, at 1:09 PM, MyDonkey wrote:

    Hey, let's not get TOO greedy! Americans are already Number 1 in obesity (among OECD countries), and we're becoming more obese every year, so the future looks bright for drug companies that treat hypertension, diabetes, cholesterol, and heart-related problems.

    If we cared more about our health and less about padding our wallets, we would be trying to decrease the amount of prescription drugs we consume, not increase it. A little more exercise and a little less eating would go a long way toward that goal.

  • Report this Comment On February 27, 2010, at 7:53 AM, JaneJohns wrote:

    LOL went for an appointment with my new doctor and he's going to work with me to get OFF the medically necesarry prescriptions my other doctor wrote me, i.e. Advair because, guess what? After years of telling us it's essential to be on a steroid inhaler if you have serious asthma, now they're telling us oops. Not so hot in the long run.So that's another "medically necessary" prescription that will remain unfilled.

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