Amid growing complaints that many Americans cannot afford their prescription medicines, most people in the U.S. who have insurance are paying lower out-of-pocket costs, but cash-paying customers are shelling out significantly more than five years ago, according to a new analysis.
Overall, the average amount paid out-of-pocket for a prescription by all patients — those with and without insurance — held steady at $10.67 in 2019, which was unchanged from the year before and up just 33 cents since 2015. But commercially insured prescription costs declined from $10.83 to $8.90 between 2015 and 2019, according to the analysis by the IQVIA Institute for Human Data Science.
At the same time, however, uninsured patients who pay cash are spending more for all types of medicines. Their costs rose to $50.78 from $36.77 for each monthly prescription between 2015 and 2019. Their cost for brand-name drugs rose, an average, to $105.74 from $93.62. Keep in mind that patients paying cash account for 21% of overall out-of-pocket costs, but only for 5% of prescriptions.
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Nice summary of an incredibly complex situation. Bottom line: The actual data show that most people pay very little for their prescriptions, despite the rhetorical exaggerations of politicians and (some) journalists.
Another unusual and confusing aspect of U.S. healthcare is the relative share of costs borne by patients for different services:
– For 2018 (most recent data), total U.S. spending on hospital care was $857 billion higher than prescription drug spending.
– However, consumers’ out-of-pocket spending for hospital care ($35 billion; 3% of hospital total) was more than $12 billion lower than consumers’ out-of-pocket spending for outpatient prescriptions ($47 billion; 14% of Rx total).
This is a insurance design problem. But good luck trying to explain these realities to the people who want to demonize one fairly small part of the U.S. healthcare system.