13M people delayed or didn’t fill prescription drugs pre-pandemic


An estimated 13 million adults delayed getting or didn’t fill prescription drugs prior to the COVID-19 pandemic due to cost, according to a new survey.

More than one-quarter of Medicare beneficiaries and 5.3% of privately insured adults spent more than 1% of their household income on their out-of-pocket prescription drug costs, according to the Urban Institute’s estimated annual averages of 2018 and 2019 Medicare Expenditure Panel Survey data from nearly 30,000 Americans. More than 3% of Medicare beneficiaries—and nearly 7% of beneficiaries with unmet prescription drug needs—spent over more than 10% of their household income on prescription drugs.

Medication adherence continued to decline while cost-sharing rose during the pandemic, which will likely lead to more hospitalizations, researchers said.

“So much of the mortality in the U.S. is preventable,” said Katherine Hempstead, senior policy adviser at the Robert Wood Johnson Foundation, adding that much of it stems from unmanaged chronic conditions. “When you are not able to take your medications, it invalidates so much of healthcare. It shortens peoples’ lives and leads to more expensive treatment down the road.”

Taking prescribed medication is crucial to better health outcomes. But rising out-of-pocket costs continue to dent adherence.

Around 10% of uninsured adults reported unmet prescription drug needs, compared with 4.9% of Medicare beneficiaries, 3% of privately insured adults and 5.6% of nonelderly adults with Medicaid, according to the Urban Institute’s research brief.

Women, people with low incomes and those with multiple chronic health conditions were most likely to forgo medication.

“This again shows us that as tough as healthcare can be, it can be even tougher for communities of color and low-income people. As you look at cost-sharing as a percentage of income, it starts to get significant really quickly,” said Dr. Harry Greenspun, chief medical officer at the consultancy Guidehouse. “Unless we start to address health equity issues on a systemic level, we will keep running into these kinds of problems.”

Rising out-of-pocket costs for prescription drugs can prove fatal, other research shows. A $10.40 increase in out-of-pocket costs per prescription was associated with a 22.6% drop in consumption and a 32.7% increase in monthly mortality rates, a recent analysis of more than 358,000 relatively healthy 65-year-old Medicare beneficiaries found.



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