PharmacyChecker Blog

Helping Americans Get The Truth About Prescription Drug Savings
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Are Drug Affordability Problems Greater In America Than Elsewhere?

The answer is yes. Out of eleven developed countries, America is #1 when it comes to high drug prices preventing people from taking needed medications, according to a new international survey conducted by the Commonwealth Fund and reported on in Health Affairs.  Twenty-one percent of American adults – over 50 million people – skipped medication due to cost, more than double the 9% who did so in Germany, the second highest rate. In the United Kingdom, only two percent of adults reported skipping medication due to drug costs.

The disturbing number of Americans forgoing prescriptions is not solely due to our large uninsured population. In fact, the Commonwealth Fund data shows that 15% of insured Americans skipped prescription medication due to costs, often because of high plan deductibles, co-payments, or co-insurance, supporting our recent analysis that those who will become insured under Obamacare may, too, find drug costs out of reach and seek affordable medication internationally. Hopefully, reforms under Obamacare, such as requiring plans to cover at least one drug in each “class” of drug and the eventual cap on out-of-pocket spending, will help Americans more easily afford their medication.

The data also shows the extent to which high drug prices affect patients with chronic conditions; skipping meds prescribed for chronic conditions, such as high blood pressure, diabetes, and asthma, can lead to hospitalizations, emergency room visits, or even death.  Twenty-nine percent of Americans with chronic medical conditions skipped their meds due to costs, more than double the 14% of Australians, who had the second highest rate.  Only 1% of patients in the U.K. with chronic conditions skipped medication because of prices. Our conclusion? America can do better.

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Will Americans Need International Online Pharmacies Under Obamacare?

This past Monday, we reported that average savings from international online pharmacies are now 87% on popular brand name meds, up from 85% a year ago. As Americans gain access to health insurance through state exchanges under Obamacare, which kicked off yesterday, will there still be a need for the international online pharmacy option?

Yes.

It may come as a surprise, but international online pharmacies benefit people with insurance, not just the uninsured. If a plan does not cover a drug, or has a high deductible or co-pay, ordering from abroad may help those on that particular plan. Fortunately, new health plans will help millions of Americans afford needed medication at neighborhood pharmacies, but some will continue to fall through the cracks.

Twenty-one percent of Americans with prescription benefits skipped filling a prescription in 2012 because of high prices, according to the Commonwealth Fund. Therefore, unless drug prices unexpectedly come down in America, we can predict that millions of Americans will still struggle with high drug prices in the U.S., and that many of them will seek relief from international online pharmacies.

There are other reasons that Americans can’t count on Obamacare to improve their access to affordable medication, especially in 2014. Due to a delay in implementing Obamacare’s spending cap of $6,350 a year, insurance plans that use more than one benefits administrator will not be subject to the cap next year. Instead, they will apply the cap to each benefit separately. Thus, Americans choosing an insurance plan that works with an independent pharmacy benefit manager may see one cap for doctor and hospital visits of $6,350 and another cap of $6,350 for medication! See our blog post “Obamacare Out-of-Pocket Cost Delays A Bad Prescription for Consumers” for more information on this topic.

Last but not least, the new plans may leave you with huge out-of-pocket drug costs if you take expensive medications.  A report in the New York Times shows that plans in some states will require patients to pay as much as 50% of a drug’s cost. Depending on the medication, 50% of a drug’s price can be prohibitive for many Americans. The Times article mentions the drug Tecfidera, which costs $4,000 a month; many Americans will struggle to make the initial payments of $2,000 or more before their out-of-pocket limit is reached.

We believe that over time Obamacare will succeed in helping millions of Americans afford medical care, including prescription medication. But the road ahead is a long one and we can’t let tens of millions continue to go without medication in the years to come. Fortunately, the lifeline of safe personal drug importation through verified international online pharmacies is available. If you choose to order from abroad, make sure you only order form a credentialed, verified pharmacy, such as those listed on PharmacyChecker.com.

We will continue to monitor and report on how Obamacare affects drug prices and access by Americans to prescription medication.

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50 Million Americans, Ages 19-64, Forgo Meds in 2012 Due to Cost; 37% of Seniors Concerned About Drug Prices

The number of Americans not taking medication due to high drug prices – a public health crisis – has increased dramatically over the past decade. Last year, drug prices deterred 50 million Americans ages 19-64 from filling a prescription, a 28% increase since 2003 and 4% increase since 2010, according to the Commonwealth Fund’s 2012 Biennial Health Insurance Survey. The survey measures gaps in medical care due to cost, such as forgone doctors’ visits, medical tests, specialist care, and prescription medications. The prescription-use data for 2012 was derived from answers to the following question: In the last 12 months, was there any time when you did not fill a prescription for medicine because of the cost? This fifty million – a staggering figure – does not even include seniors or children who also did not fill a prescription due to cost.

Not surprisingly, the problems for the uninsured are much greater, especially for those with chronic conditions. Sixty percent of uninsured Americans with a chronic condition skipped taking medication in 2012 due to cost, compared to 14% of insured Americans. Overall, the figure was 28%; that’s 18 million out of sixty-six million adults with hypertension or high blood pressure, diabetes, asthma, emphysema, lung disease, or heart disease who reported skipping medication.

As far as seniors skipping meds goes, a recent Walgreens survey may have some answers. It found that 37% of Medicare enrollees are concerned about their drug costs and 20% delay filling prescriptions or skip doses to manage costs. That’s almost an additional eight million (using U.S. Census data for 2011) Americans not adhering to prescriptions due to high drug prices. Walgreens attributes such dismal numbers to the fact that people are unaware of cost-saving alternatives, such as the fact that co-pays vary among pharmacies and limited knowledge of how Part D prescription plans work.

Other reasons seniors skip medication are because their Part D plans do not cover brand name medications prescribed by their doctors and the “donut hole,” a coverage gap in Medicare drug plans that has fortunately begun to close due to Obamacare .

We’re happy to note that the Commonwealth Fund’s report shows that more insured Americans under Obamacare in the years to come could alleviate medical cost problems for millions of Americans. We’ll explore in a future blog post new data on how Americans are addressing the problem of high drug prices.

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