A recent article from Managed Care magazine shows that many Americans are struggling to keep up with the high price of prescription drugs.

Deciding whether you can afford to buy something you want, like a new dress or phone upgrade, can seem like a tough decision, especially if it is just out of your financial reach. But what happens when you’re deciding between keeping the lights on in your home or buying prescription drugs?

The increasingly high price of drugs is causing many Americans to make this desperate choice and while your wallet may hurt from paying the price of those high-cost drugs, the truth is that going without necessary prescription drugs could kill you.

This desperate dilemma has become an everyday reality for many Americans.

In a recent article, Managed Care magazine argued that unaffordable medicine is hurting individual patients. Last February, Heather Holland recoiled at the cost of her $116 Tamiflu prescription and died in the ICU days later. The Managed Care magazine article went on to cite a statistic from a December AARP report that drug retail prices had increased substantially for “at least” the 12th consecutive year.

The article found that four major pharmaceutical companies made headlines by announcing they would only increase prices by single digit percentages last year. Yet, they still left room for price hikes that were many multiples of the current rate of inflation. And, the group found that as expensive new drugs have entered the market in recent years, out-of-pocket burdens have risen as consumers are asked to bear a larger share of the cost through high-deductible health insurance plans and so-called prescription “donut holes” that appear in some plans.  

Dr. R. Adams Dudley, a pulmonologist who directs the Center for Healthcare Value at the University of California–San Francisco, said that the problem “definitely” impacts patients’ lives.

“They’re skipping medicines or skipping other things to buy medicines,” Dudley said in the article. “To many people, $160 is a lot of money. But almost anyone would rather spend it taking the family to dinner than paying for a medicine that costs three dollars to make.”

But it gets worse. Per the article, some experts have estimated that about 20% of American adults have passed up prescribed medicine as a result of its cost. What’s even more startling is that the rate of prescriptions that are abandoned — medication approved by insurance but never picked up — is still high when out-of-pocket costs are high, even when the patient is facing conditions like chronic myeloid leukemia, rheumatoid arthritis, diabetes and multiple sclerosis.

Some doctors are trying to combat this problem by looking to prescribe lower-cost treatment plans to fit a family’s financial situation, but it isn’t always easy. The average wholesale price of a drug — which one health system listed in the article provides to clinicians for the sake of transparency —  is one key tool. With that price point, doctors are really looking at the combined cost of the drug to the health plan and the patient, and it can be difficult to separate the two and estimate an individual’s out-of-pocket cost.

The article concludes with a stark warning, that when cost-prohibitive medications cause patients to drop or skip their prescriptions, the effect is not just a reduction in a life’s quality, it can actually shorten life spans.

“The problem of unaffordable drug prices is one of those messy socioeconomic-slash-political afflictions—like the breakdown of our gridlocked political system—whose main sequelae seem to be the wringing of hands and the pointing of fingers,” the article reads. “But make no mistake: People are hurting.”