Cybercitizens' ranks expand as Americans face increasing health cost burdens

There is good news and bad news in the rich data mine that is the latest version of Manhattan Research's Cybercitizen Health survey. On the positive side of eHealth, the number of Americans who are seeking health information online has more than doubled since 2002.

On the downside, nearly 40 million Americans did not fill a prescription due to cost. This isn't just for preparations that are available over-the-counter or those for nasal allergies.

The top ten conditions that people not filling prescriptions haven't filled cover a great many mental health conditions, along with pain and assorted other maladies that negatively impact quality of life.

Intriguingly, 3 of these conditions for which Rx's aren't always getting filled are in the top 5 conditions for which consumers use Health 2.0 content. They are ADD/ADHD, Inflammatory Bowel Disease, and Acute Pain.

Manhattan Research defines Health 2.0 Consumers as, "consumers who have conducted one of the following activities in the past 12 months: read health-related blogs, message boards or participated in health-related chatrooms; contributed or posted health content online such as: writing or commenting on a health-related blog, adding or responding to a topic in a forum or group, or creating health related web pages, videos or audio content; used online patient support groups, message boards, chatrooms, or blogs."

Based on this definition, Cybercitizen Health found that 27% of U.S. adults use Health 2.0 content and services online in the past 12 months.

Another key trend discovered this year is that, for the first time, Americans use the Internet as the go-to source for health information -- not the doctor. While physicians, nurses and pharmacists are seen as highly relevant -- even more so than the Internet -- the percent of U.S. adults using the Internet for health information exceeds that of these other clinical "live" sources.

Health Populi's Hot Points: The issue of patients' compliance with prescription drug regimens has challenged drug companies, health plans and physicians for years. The era of higher copays (for branded and specialty drugs), higher copays for physician visits, greater levels of coinsurance, and declining funds in personal pocketbooks is upon us.

If people with serious chronic conditions aren't filling their prescriptions, they're not taking their medicine. This will ultimately exacerbate costs in the longer term for the individual, the health plan, the local hospital (who might admit the patient with complications into the emergency department), and the health system at large.

The specific instance of mental health conditions bears special mention. The Mental Health Parity Law passed on October 3, 2008, will go into effect on January 1, 2010. That's about one year from now.

The law will will is aimed at reducing out-of-pocket costs for mental health care for health plan participants. When a health plan offers mental health coverage, the law requires equity in financial requirements such as deductibles, co-payments, coinsurance, and out-of-pocket expenses. This should help those with health coverage more effectively access mental health services and drugs.

For those without drug coverage, the cost problem will exacerbate mental health outcomes through 2009 and beyond.

In the meantime, Americans managing, or trying to manage chronic conditions will seek solace and advice through social networks enabled by Web 2.0 technologies. Look for those interactions and patient-to-patient bonds proliferate and solidify in 2009.