A recent survey by the Pharmaceutical Research and Manufacturers of America (PhRMA) sheds light on a significant issue: many Americans, even those with health insurance, are struggling to afford prescription medications. The Patient Experience Survey revealed that over half of insured Americans (51%) cannot accurately predict their prescription costs, while a sizable 38% reported rising out-of-pocket expenses for their medications.
The Burden of Out-of-Pocket Costs
Rising health care costs have created a burden for insured Americans, with nearly half (46%) indicating that their out-of-pocket expenses for prescriptions are either too high or unaffordable. Key reasons behind this financial strain include:
- High Deductibles: Nearly half (43%) of respondents cited high deductibles as a major contributor to their financial burden.
- Unaffordable Copays: 20% of respondents reported that they struggle to afford their copays.
- Lack of Coverage: 19% noted that their insurance does not cover some essential services or medications, adding to their financial strain.
- Unaffordable Coinsurance: 16% mentioned that coinsurance fees made it difficult to afford their medications.
These financial pressures are especially concerning for individuals facing a major medical event or dealing with a chronic condition. Even with insurance, many respondents reported that their out-of-pocket expenses for necessary treatments would be more than they could manage.
Impact on Medication Adherence
High prescription costs have led many Americans to make difficult choices regarding their medication adherence. According to the survey:
- 1 in 3 patients reported challenges in following their prescribed treatments due to cost barriers.
- To cope, many patients resorted to measures like skipping doses, delaying treatment, or cutting pills in half.
- Some respondents admitted to not finishing their medication or avoiding it altogether due to financial constraints.
These actions can have serious health implications, particularly for those managing chronic illnesses where consistent medication is crucial for effective treatment.
Additional Challenges in Health Care Affordability
The PhRMA survey also highlights broader concerns Americans face with health care coverage:
- Only 28% of Americans believe their insurance provides affordable access to necessary care.
- 52% worry about their ability to manage out-of-pocket costs and insurance premiums over the next year.
These statistics point to a broader issue within the healthcare system, where many insured individuals still feel financially vulnerable.
Key Takeaways for Employers
The findings from the PhRMA survey underscore the importance of affordable health care as a top concern for many Americans. For employers, this survey serves as a reminder to stay informed about prescription drug costs and trends. By carefully evaluating health care plan designs and considering the impact of cost-sharing on employees, employers can help ensure their workforce has better access to essential treatments without compromising financial security.
Final Thoughts
As health care costs continue to rise, Americans face growing challenges in accessing affordable prescriptions and managing out-of-pocket expenses. With many patients forced to alter their prescribed treatment plans due to cost, there is an urgent need for strategies that address affordability. Both individuals and employers play a role in advocating for more transparent, accessible, and affordable health care solutions.