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High Drug Costs Bar Care Access, Medication Adherence for 13M Adults

High drug costs are particularly salient for women, people with low incomes, and chronically ill people, leading to care access and medication adherence hiccups.

High drug costs served as a care access and medication adherence barrier for nearly 13 million adults before the pandemic, according to a new report from the Robert Wood Johnson Foundation and Urban Institute.

Particularly, the report said 13 million adults did not fill a prescription or delayed filling a prescription because of high cost. That includes 2.3 million Medicare beneficiaries and 3.8 million privately insured working-age adults who skipped necessary treatments due to high healthcare and drug costs.

The data, taken from the 2018-2019 Medical Expenditure Panel Survey, is from well before COVID-19 came ashore in the US and reshaped the way the nation views healthcare, the researchers acknowledged. Nevertheless, insights into cost-related care access and medication adherence barriers from before the pandemic should shape the industry’s post-pandemic policymaking.

“It’s tragic that millions of people don’t take needed prescription drugs because they can’t afford them,” Katherine Hempstead, senior policy adviser at the Robert Wood Johnson Foundation, said in a statement emailed to journalists. “As we recover from COVID-19 and try to create a more equitable society, ensuring that prescription drugs are affordable must be a policy priority.”

Patients are keenly feeling the rising costs of medical services on their own pocketbooks, the analysis showed. More than a quarter of Medicare beneficiaries and 5.3 percent of privately insured adults spent more than 1 percent of their family income on their out-of-pocket prescription drug costs.

This is a fairly notable finding, the report authors said. Phrased otherwise, 1 in every 100 dollars spent went toward prescription drugs in a given year.

“Though most adults with Medicare or private coverage had modest out-of-pocket costs for prescription drugs, some experienced high spending burdens relative to their incomes, which could further exacerbate unmet needs for other types of care and limit resources for other needs,” the report authors wrote.

For some families, the costs were greater. Over 3 percent of Medicare beneficiaries spent more than 10 percent of their family income on prescription drugs. For Medicare beneficiaries with unmet prescription drug needs, that figure is about 7 percent, meaning these patients spent a tenth of their family income on prescription drugs and still didn’t have all they clinically needed.

Prescription drug cost burden was worse for individuals without insurance coverage for all or part of the year, the data furthered. These individuals had high rates of unmet prescription drug needs due to high drug costs.

About a tenth of those who were uninsured for all of the year said they had unmet prescription drug needs, and 11.6 percent of those who were uninsured for part of the year said the same. That compares to 4.9 percent of Medicare beneficiaries, 3 percent of privately insured adults, and 5.6 percent of non-elderly Medicaid beneficiaries who had unmet prescription drug needs.

And like so much of the medical industry, these care access and cost limitations yielded keen health disparities, particularly among women, people with low incomes, and people with multiple chronic illnesses.

These findings carry with them serious policy implications, the report authors said. Given the heavy cost burden for prescription drugs, and the care access and medication adherence barriers that result from those costs, the report authors recommended future healthcare policy create drug pricing reforms.

“Millions of adults go without needed medications each year because they cannot afford them,” Michael Karpman, senior research associate at the Urban Institute, said in a press release about the report. “Policies to reduce drug prices, limit out-of-pocket costs, and expand health insurance coverage could help many people get the prescription drugs they’re currently unable to pay for.”

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