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Studies and Resources
NCSL | November 1st, 2022
Prescription drugs are often a vital part of a person’s daily health regimen, but the cost of treatment can be a barrier for some. In fact, data from a Kaiser Family Foundation poll shows 1 in 4 Americans reporting difficulty affording their medicine.
Many chronic conditions are treated with biologics (drugs made from living cells), brand-name or “specialty” drugs, which can be particularly costly. In one analysis, researchers evaluated the prices of six specialty drugs between 2014 and 2018 and found prices rose on average 57%, while prices for generics decreased 35%. Additional research shows specialty drugs make up 37.7% of retail prescription drug spending, even though they account for a small portion of prescriptions filled.
Discriminatory Copay Policies Undermine Coverage for People with Chronic Illness
The AIDS Institute | January 2022
Patients with rare, complex, or chronic diseases such as HIV and hepatitis C often need highcost specialty medications to manage their conditions and maintain their health. Over the past decade, insurance companies have increasingly shifted the cost of these specialty medications to patients by raising deductibles and the amounts of copayments or coinsurance that patients must pay when they buy their medications.
As a result, many patients with such diseases – including those with health insurance – must rely on financial assistance from charitable foundations and drug manufacturers. Drug manufacturers’ copay assistance programs play a crucial role in helping patients who rely on expensive medications meet those cost-sharing obligations and afford their medication throughout the year. These programs provide a true financial lifeline for many people living with chronic conditions.
Patients & Family Caregivers: Prescription Drug Affordability Challenges During COVID-19
National Hemophilia Foundation | April 29, 2021
More than half of respondents with private coverage (55%) report they or their loved one has a high deductible health plan. Out-of-pocket health care costs is the biggest problem affecting these patients and their families.
Most patient and caregiver respondents say they are familiar with copay assistance programs. Roughly two-thirds report they or their loved one are either currently using or have used copay assistance programs for their medications.
