(Bloomberg) -- Adults who haven’t reached retirement age were twice as likely as those who have to skip their prescribed medications to save money, a U.S. study finds.

About 20% of adults regardless of age have asked their doctors for a lower cost treatment, according to the study released Tuesday by the Atlanta-based Centers for Disease Control and Prevention. Spending on drugs is expected to increase an average of 6.6% a year from 2015 through 2021, the Kaiser Family Foundation has reported.

Americans spent $45 billion out-of-pocket on retail prescription drugs in 2011, the CDC says. The Patient Protection and Affordable Care Act is expected to expand access in 2014 when medication coverage is considered an essential benefit of any health plan offered in new insurance marketplaces called exchanges.

“If you’re not insured or you face high co-payments, you’re going to stretch your prescriptions,” says Steve Morgan, an associate professor at the University of British Columbia’s School of Population and Public Health in Vancouver. “Even among insured populations, there is this invincibility mindset among the very young. Older people are more likely to adhere to chronic therapies over a longer period of time than younger.”

Tuesday’s study found 13% of those ages 18 to 64 reported not taking their medications as prescribed to reduce costs compared with 5.8% of those 65 and older. The 2011 data came from the National Health Interview Survey. Most U.S. adults are eligible at age 65 for Medicare, the federal government’s health program.

About 90% of seniors and 57% of non-elderly adults had a prescription drug expense in 2010, according to the Kaiser foundation, a nonprofit health research group based in Menlo Park, Calif.

Strategies that alter the way adults take their medications include skipping doses and consuming less than the prescribed amount. About 11% of those 18 to 64 also delayed filling a prescription compared with 4.4% of those 65 and older, according to the survey. Uninsured adults were more likely to have tried to stretch their medications than those with Medicaid, the federal-state health program for the poor, and those with private insurance.

Failing to take medication as prescribed may increase costs to the U.S. health system, particularly from exacerbated conditions that lead to increased hospitalizations, Morgan says.

About 2% of adults regardless of age bought prescription drugs from another country to reduce costs.

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