Prescription drug costs

"Prescription drugs don't work if you cannot afford them," said Dan Witters, a senior researcher at Gallup. (Photo: iStock/via Getty)

Nearly 18 Million US Adults Couldn't Afford a Prescription Medication This Year: Study

The finding came as the Biden administration unveiled its plan to allow the government to negotiate drug prices directly with Big Pharma.

Around 15.5 million U.S. adults under the age of 65 and 2.3 million seniors were unable to afford at least one doctor-prescribed medication this year, according to a study released Thursday as the Biden administration unveiled its plan to reduce the nation's sky-high drug prices.

The new study (pdf) was based on four nationally representative surveys conducted in recent months by the polling outfit Gallup in partnership with West Health, a nonprofit organization focused on lowering healthcare costs.

"Ending the pharmaceutical industry's monopoly control over drug pricing is long overdue."
--Margarida Jorge, Lower Drug Prices Now

Asked whether "you or a family member skipped a pill to save medication in order to save money" over the past 12 months, 10% of survey respondents answered in the affirmative, with the impact falling most heavily on lower-income households.

Seven percent of poll respondents told Gallup/West Health that there has "been a time in the last three months" when they or a member of their household have been "unable to pay for medicine or drugs that a doctor had prescribed" because they "did not have enough money." People who are immunocompromised couldn't afford their prescription medicines at almost twice the rate of Americans generally, Gallup and West Health found.

"Prescription drugs don't work if you cannot afford them," Dan Witters, a senior researcher at Gallup, said in a statement. "Across multiple studies, we are measuring adults from all age, race, and ethnic groups, political parties, and income levels are reporting that they are struggling to afford medications. And amidst these reports are strong and consistent sentiment for more government action to rein in costs."

The study was published as the Biden administration released the details of its proposal to slash U.S. prescription drug prices, which are often two to four times higher than those of other rich nations.

Under the Biden administration's plan, the Health and Human Services (HHS) secretary would be empowered to negotiate Medicare Part B and Part D drug costs directly with pharmaceutical companies, and the resulting prices would be made available to Medicare recipients, private insurance plans, and employers that opt to participate.

The plan would also impose a cap on "catastrophic spending" to shield Medicare Part D enrollees from massive out-of-pocket costs. According to the Kaiser Family Foundation, nearly 1.5 million Medicare Part D beneficiaries in 2019 had out-of-pocket prescription drug spending above the catastrophic coverage threshold, which is currently $6,550.

"Life-saving prescription medication should not cost anyone their life savings," HHS Secretary Xavier Becerra said in a statement. "Yet too often, many low-income families cannot take their prescription medications because of cost concerns... By promoting negotiation, competition, and innovation in the healthcare industry, we will ensure cost fairness and protect access to care."

Many of the drug-pricing reforms outlined by the Biden administration on Thursday would require congressional action, and Democratic lawmakers are expected to include some of the proposals--such as a Medicare negotiation provision--in their emerging reconciliation bill. Unsurprisingly, the pharmaceutical industry is lobbying hard against efforts to cut soaring medicine prices, which pad drug companies' bottom lines.

Confirming other recent polling, the Gallup/West Health study found that 81% of U.S. adults believe the "government needs to play a
major role in negotiating prescription drug prices for Medicare in order to control costs." The study also showed that just 19% of U.S. adults believe the pharmaceutical industry's claim that "allowing government to negotiate drug prices for Medicare will hurt pharmaceutical competition and innovation."

Margarida Jorge, campaign director for Lower Drug Prices Now, said in a statement Thursday that allowing Medicare to negotiate drug prices "would not only lower costs for seniors, families, and employers, but it would also produce half a trillion dollars in savings for taxpayers."

"Today President Biden made it abundantly clear that lowering prescription drug prices is essential for our country to 'Build Back Better,'" said Jorge. "As Congress debates the reconciliation bill, we urge members to follow through on their promises with this once-in-a-generation opportunity to make prescription drugs more affordable and show they are on the side of patients."

"Ending the pharmaceutical industry's monopoly control over drug pricing is long overdue," she added. "It's time to put healthcare before wealthcare--no one should have to worry about affording the medicines they need, especially when pharmaceutical corporations continue to be the most profitable sector in the nation."

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