Prescription Drug Access Problems Remain Level Between 2007 and 2010

More than 1 in 8 Americans Could Not Afford to Fill Prescriptions in 2010

News Release
Dec. 16, 2011

FURTHER INFORMATION, CONTACT:
Alwyn Cassil (202) 264-3484 or acassil@hschange.org

WASHINGTON , DC—Despite the weak economy and more people lacking health insurance, the proportion of Americans reporting problems affording prescription drugs remained level between 2007 and 2010, with more than one in eight going without a prescribed drug in 2010, according to a national study released today by the Center for Studying Health System Change (HSC) and funded by the Robert Wood Johnson Foundation (RWJF).

The most vulnerable people—the uninsured, those with low incomes, people in fair or poor health and those with multiple chronic conditions—continued to face the most unmet prescription needs,  according to findings from HSC’s 2010 Health Tracking Household Survey, a nationally representative survey with information on 17,000 people. Funded by RWJF, the survey for the first time included a cell phone sample to account for the growing number of households without a landline phone. Response rates were 45 percent for the landline sample and 29 percent for the cell phone sample.

“About one out of two uninsured people in fair or poor health couldn’t afford a prescription drug in 2010, almost double the rate of insured people in the same health,” said Ellyn R. Boukus, M.A., HSC health research analyst, and coauthor of the study with HSC Senior Researcher Emily R. Carrier, M.D., M.S.C.I.

While prescription drug access remained stable for most Americans in recent years, uninsured, working-age adults (aged 19-64) saw a significant decrease in unmet prescription drug needs, from 35.9 percent in 2007 to 29.4 percent in 2010, according to the study. Some portion of the decrease in access problems likely reflects that fewer uninsured people reported visiting a health care provider in 2010 compared with 2007. As a result, they were less likely to have the opportunity to have any medications prescribed.  

Likewise, elderly people eligible for both Medicare and Medicaid saw a sharp drop in prescription drug access problems. After doubling between 2003 and 2007, unmet prescription drug needs for dually eligible, elderly Medicare beneficiaries dropped from 21.7 percent in 2007 to 8.0 percent in 2010.

Given the large increase in the uninsured population—from 42.8 million in 2007 to 51.7 million in 2010—and financial pressures caused by the severe economic recession and sluggish recovery, the study points out that it is somewhat surprising that drug affordability problems did not increase.

Possible explanations include people reducing their use of medical care in response to the weak economy—fewer physician visits may have led to fewer prescriptions being written. Other factors also likely made some prescriptions more affordable for patients, including the loss of patent protection for several major branded drugs and additional shifts toward generic use, as well as lower generic prices.

The study’s findings are detailed in a new HSC Tracking Report—Americans’ Access to Prescription Drugs Stabilizes, 2007-2010—available online at www.hschange.org. Other key findings include:

• In 2010, two-thirds of all Americans—and nearly 90 percent of seniors—reported taking at least one prescription drug in the past year.
• The number and percentage of Americans reporting unmet prescription drug needs because of cost concerns remained significantly higher in 2010 compared to 2003 (13% vs. 10%), largely reflecting an increase in access problems for children and working-age adults (aged 19-64) between 2003 and 2007.
• People with private insurance experienced relatively few problems, with only 9.8 percent of working-age adults and 4.2 percent of children reporting an unmet prescription need in 2010.
• Uninsured people continued to have the most problems affording prescription drugs. Overall, 27.4 percent of uninsured people reported prescription drug access problems in 2010, or nearly three times the rate for insured people.
• Uninsured people with multiple chronic conditions were the most vulnerable population: 69 percent reported an unmet prescription need because of cost in 2010, compared with 20 percent of insured people with multiple chronic conditions.
• In 2010, people with incomes below 200 percent of poverty—$44,100 for a family of four—were 3.4 times more likely to report drug access problems as those earning 400 percent of poverty or more—19.3 percent vs. 5.7 percent.

The Center for Studying Health System Change is a nonpartisan policy research organization committed to providing objective and timely research on the nation’s changing health system to help inform policy makers and contribute to better health care policy. HSC, based in Washington, D.C., is affiliated with Mathematica Policy Research.