Prescriptions more affordable after U.S. policy changes

Still, more than 20 million adults say they have a hard time paying for their medications.

The study demonstrates that an important health measure like getting prescriptions filled can respond "to changes in the health policy environment," the researchers write in the most recent issue of the American Journal of Public Health.

Jae Kennedy, professor and chair of the Department of Health Policy and Administration at WSU's College of Nursing, led the analysis of National Health Interview Surveys 1999-2015. He and co-author Elizabeth Geneva Wood, a WSU research scientist, found that at the height of the Great Recession in 2009, 25.1 million Americans did not fill a prescription in the previous 12 months because they could not afford it. That's nearly one out of every 10 Americans.

The researchers then broke out the trend lines by age group. With the exception of seniors, almost all groups reported increasing difficulty paying for prescriptions from 1999 to 2009. Reported medication cost problems for Americans over age 65 peaked at 5.4 percent in 2004, and dropped to 3.6 percent by 2006, when the new Medicare Part D program was fully implemented.

As the economy improved, most age groups reported improvements in their ability to pay for prescriptions. However, the percentage of adults aged 19-25 who said they could not afford to fill a prescription dropped steeply, from 10.8 percent in 2010 to 8.2 percent in 2011, as the Affordable Care Act let young adults stay on their parents' health insurance plans.

Another drop occurred among working-age adults aged 26-64 after full implementation of the Affordable Care Act in 2014. With establishment of health insurance marketplaces in each state and expanded Medicaid eligibility in 27 states, rates of prescription affordability problems among adults aged 26-64 fell from 9.1 percent in 2013 to 7.9 percent in 2014.

"The takeaway is that health policy matters," said Kennedy. "In both Republican and Democratic administrations, program changes in health care financing were associated with improved prescription affordability."

However, the authors noted that about 16.4 million Americans still report difficulty in paying for prescriptions. The researchers suggest that additional improvements might follow if more states opt to participate in the Medicaid expansion.