13M Americans skip medication due to high prescription cost, survey says

Study prompted by efforts to lower prescription costs and pending provisions under Build Back Better

Nearly 13 million Americans skipped or delayed prescribed medicine in the year before the COVID-19 pandemic due to high costs, according to a recent survey. 

The Urban Institute, a nonprofit research organization, said the total included 2.3 million elderly Medicare beneficiaries, 3.8 million non-elderly adults with private insurance, 1.1 million with Medicaid and 4.1 million who were uninsured at any point during the year.

Using 2018 and 2019 data from the Medical Expenditure Panel Survey, the group said around 1 in 10 adults who were uninsured all year or part of the year reported unmet prescription drug needs, in comparison to lower percentages of Medicare beneficiaries, privately insured adults and adults with Medicaid.


For Medicare beneficiaries and privately insured adults, unmet prescription drug needs were most common among women, people with low incomes and people with multiple chronic health conditions. 

In addition, nearly all Medicare beneficiaries and more than 8 in 10 privately insured adults with unmet needs have been diagnosed with a chronic condition like high blood pressure, stroke, diabetes, respiratory illnesses, high cholesterol and arthritis. 

More than one-quarter of adults with Medicare and 5.3% of privately insured adults spent greater than 1% of their family incomes on their individual out-of-pocket prescription drug costs. 

More than 3% of Medicare beneficiaries, as well as nearly 7% of beneficiaries with unmet prescription drug needs, spent more than 10% of their family incomes on prescription drugs.

"Policies to reduce drug prices and limit out-of-pocket spending could increase access to needed prescription drugs for adults with Medicare and private coverage, and efforts to expand coverage to the uninsured population could further improve prescription drug affordability," Urban Institute said in a statement. 


"The ability to afford prescription drugs can have very significant consequences for a person's health," Michael Karpman, lead researcher of the study, explained to Verywell Health last Friday. "There have been other studies showing that when patients are not able to get their medications or don't adhere to the medications that they're prescribed, that can lead to worse health problems and more expensive treatments down the road."

Karpman told the publication that the study had been prompted by current government efforts to lower prescription costs and the pending provisions under the roughly $2 trillion Build Back Better Act, which seeks to close insurance coverage gaps and limit drug price increases. 

The researcher said his team was specifically interested in how many people who used Medicare or commercial insurance encountered financial hurdles to prescriptions, as they could be the most affected by potential reforms in Congress.

The Verywell Health report also cited an October 2021 Kaiser Family Foundation (KFF) poll on prescription drug prices that found about three in 10 adults reported not taking medicines as prescribed at some point in the past year due to the cost, including about one in six who reported not filling a prescription, one in five who took an over-the-counter drug instead and 13% who said they had cut pills in half or skipped a dose. 


Those who take four or more prescription drugs, people with chronic conditions in their households and those with an annual household income of less than $40,000 were much more likely to report difficulty affording medication.

The KFF poll said that while about eight in 10 said profits made by pharmaceutical companies are a "major factor" in the price of prescription drugs and about seven in 10 blame the cost of research and development, six in 10 adults said prescription drugs developed over the past two decades have generally made the lives of American better.