Medication Access in the US⁠—It Impacts Us All

Medications can help improve the quality and duration of our lives, but not taking it can be deadly and causes implications far beyond the health of one person. We all know that modern medicine can prevent a stroke, minimize the impact of cancer, dull the pain of arthritis, ward off depression and more. However, we never really talk about what it looks like to not take (or not have access to) the medications you need. Furthermore, those of us who can afford or easily access the medications we need tend to not understand the financial ripple effect that occurs when someone doesn’t take their required medicine. Nearly six in ten Americans report the medical need to take at least one prescription drug; however, the harsh reality for 1 in 4 adult Americans is that they cannot afford the medication they need to survive and be healthy.  Whether you’re one of those that can afford your medication, or one of those that can’t, access to medication in the US impacts each and every one of us daily.

Medication Access in America

The lack of affordable and accessible prescription drugs is a uniquely American problem amongst other developed nations, despite The United States of America being one the wealthiest countries in the world. Contributing to this is the overall private healthcare structure and lack of regulation on drug pricing. From 2014 to 2021, prescription drug list prices increased 35.5% across all categories, with the national brands increasing 78.2%, while generics actually decreased -29.6%.

For instance, with almost half of Americans living with diabetes or prediabetes, insulin costs increasing 41% from 2014 to 2020 has undoubtedly impacted the daily lives of our family, friends, and/or neighbors. “I have patients who tell me that they have to make a decision between food and insulin, and their rent and insulin.” said a Montana doctor. Drug costs well-outpacing inflation rates have forced people to make impossible choices. With the continuous rise in prescription drug costs, it’s not surprising that many Americans opt for not taking their medicine as prescribed, or in numerous cases, not at all. “It is very unaffordable for people to use most medications if they don’t have insurance,” said Stacie Dusetzina, a health policy researcher at Vanderbilt University who has studied drug affordability. 

Contrary to popular belief, this problem doesn’t simply boil down to insured vs. uninsured: Americans with health insurance are still unable to meet all their prescription copayments. Since the early 2000s, the trend of employers is to embrace high deductible healthcare plans to encourage employees to cut-back needless spending. Studies have shown this has actually forced employees to skip medication or put off routine preventative care due to cost. With Americans spending on average $5,000 annually on out-of-pocket health care costs, a staggering 32% of insured working Americans have medical debt. To put that into perspective, the average single American’s out-of-pocket medical costs are slightly more than a US household’s average grocery costs. When faced with a choice, the short-term need to feed their family often weighs out over the preventative need to take their medication.

The Impact of Not Taking Medication as Prescribed

Skipping or reducing necessary medication consumption has a major direct impact on the patient and their family, but also directly impacts all American taxpayers. In fact, more than 125,000 people die every single year in the United States due to medication non-adherence. The annual death toll is more than car accidents and opioid overdoses combined. There are also countless secondary impacts, from increased absenteeism at work to medical debt bankruptcy and then come even more repercussions. Costs for not taking medication as prescribed are estimated by the Centers for Disease Control and Prevention to reach $300 billion annually in the U.S. To help illustrate the issue, consider for a diabetic patient, every additional dollar spent on taking and adhering to prescribed medications would result in a $7 reduction in future medical costs. This is where the crisis impacts not only our hearts, but also every one of our pocketbooks through increased taxes and rising medical expenses to cover non-payment. 

Serious problems can occur when medications are not taken as prescribed, leading to emergency medical intervention, expensive treatment and surgeries, and many unnecessary complications. A lack of preventative medicine is associated with higher hospitalization rates, lower health outcomes, increased illnesses, a shorter lifespan, and higher health care cost for everyone. For example, skipping insulin with type 2 diabetes wreaks havoc on a person’s over-all well-being, can result in the need for major life-saving surgery, and other costly treatments. This is because high blood sugar affects many organs and cells in the body and can lead to kidney damage, blindness, increased risk of heart disease and stroke, chronic conditions like neuropathy and gastroparesis, and in severe cases, diabetic coma, and death. 

Medication Access:  It Matters for One, It Matters for All

As Americans, medication access directly and indirectly impacts all of us. Whether it’s your sister, aunt, or best friend that cannot afford medication for her autoimmune disease, the continuous rise in your insurance’s annual deductible, or the increased out-of-pocket cost of an emergency room visit, medication access permeates our daily lives. This crisis exists right now in our own communities, yet it is extremely underrepresented in the media and conversations around healthcare. Help us start the conversation to inform Americans on medication access inequity and the ways in which we can all be a part of the change.