Nearly 13 million adults just before the pandemic had problems affording their prescriptions due to cost, a new study found.
The study, published Wednesday by the Urban Institute, found that most adults who delayed or did not get needed pharmaceuticals were uninsured. The results come as Congress is debating legislation to cap out-of-pocket costs in Medicare amid other reforms.
“Policies to reduce drug prices, limit out-of-pocket costs and expand health insurance coverage could help many people get the prescription drugs they’re currently unable to pay for,” said Michael Karpman, senior research associate for Urban, in a statement.
The analysis looked at data from the Medicare Expenditure Panel Survey’s household component from 2018 and 2019, a national survey of households.
Of the 13 million people who delayed or didn’t get care, 4.1 million of them did not have insurance at any point during the year. Another 3.8 million had private insurance, with 2.3 million in Medicare and 1.1 million from Medicaid.
“For both Medicare beneficiaries and privately insured adults, unmet prescription drug needs were most common among women, people with low incomes and people with multiple chronic conditions,” the study said. “Nearly all Medicare beneficiaries and more than 8 in 10 privately insured adults with unmet needs have been diagnosed with a chronic condition.”
Urban also found that 25.4% of Medicare beneficiaries and 5.3% on private insurance spent more than 1% of their family incomes on out-of-pocket drug costs.
More than 3% of beneficiaries spent more than 10% of their incomes on drugs.
The study comes as Democrats are pushing to include legislation that creates an out-of-pocket cost cap to Medicare for pharmaceuticals. The provisions in the Build Back Better Act also include giving Medicare the power to negotiate a narrow subset of drugs in Medicare Parts B and D and install an out-of-pocket cap on insulin costs at $35.
The House passed the legislation last month, and Democratic leadership is hoping to pass it before Christmas.
Urban noted that while most adults didn’t face difficulty affording prescription drugs, the study took place before the COVID-19 pandemic in 2020 that caused millions to delay getting care.