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Americans Skip Prescriptions Due to Cost
16 Dec
Summary
- 1 in 5 U.S. adults skip prescriptions annually due to cost.
- Millions struggle with copays, coinsurance, and unmet deductibles.
- New Medicare cap and payment plan aim to lower drug expenses.
Millions of Americans face challenges affording prescription drugs, even with health insurance. Approximately 20% of U.S. adults annually skip prescriptions because of their price, while many more resort to measures like splitting pills. This financial burden stems from complex insurance structures involving copays, deductibles, and the increasing use of coinsurance, which shifts a larger cost percentage to patients.
Significant changes are expected for Medicare beneficiaries starting in 2026. A new cap will limit annual out-of-pocket prescription drug expenses to $2,100, with potential for even lower costs. Additionally, the Medicare Prescription Payment Plan, launched in 2025, aims to make drug expenses more predictable by spreading costs throughout the year.
Patients facing unaffordable copays can explore options like discount cards from GoodRx, which compare prices and offer coupons. Prescription assistance programs sponsored by drugmakers, nonprofits, and government agencies also provide crucial support. While some direct-to-consumer platforms are emerging, their high cash prices and lack of insurance coverage limit their accessibility for many.
