OBJECTIVES: Compliance with medications among elderly patients is particularly important, as the consequences may be quite serious.  Results suggest that use of three or more medications may put a considerable burden on elderly patients and may affect their compliance.1 This analysis profiles elderly patients across 5EU by the number of medications currently used and their compliance related behaviors. Combination products were considered as one prescription medication. METHODS: Results were taken from the 2011 5EU National Health and Wellness Survey, a nationally representative, self-administered survey.  Respondents were adults age 18 and over from France, Germany, Italy, Spain and UK.  This analysis focuses on adults age >= 65.  Physical and mental quality of life was measured using the SF12v2 scale.  Activity impairment was measured using the Work Productivity and Activity Impairment scale. RESULTS: Out of the total sample of age >=65 (n=10,612), ~37% of elderly adults across 5EU currently use four or more  prescription (Rx) medications to treat their conditions, 44% use 1-3 Rx medications, and 18% use no Rx medications.  Activity impairment is greater among those using 4+ medications (38.6 vs. 22.7 vs. 16.0).  Emergency room visits and hospitalizations are also higher.  This group appears to be more proactive in engaging in cost-saving behaviors to alleviate some of the treatment costs in the past 6 months (30% vs 24% vs 15%) (e.g., asking for generic alternatives (19% vs 16% vs 8%), ever changing prescription to another drug (61% vs 51% vs 45%) and switching to a generic version of a prescribed drug (35% vs 27% vs 18%). CONCLUSIONS: Considerably higher healthcare costs and greater activity impairment can be seen among elderly patients using more prescription medications.  Given the financial burden of using multiple medications, and the lower incomes of these patients, cost-saving methods are more frequently utilized by these patients.