A healthcare paradox: Drugs are too expensive but ‘easy’ to afford, Americans say

The majority of Americans believe prescription drugs are too expensive, but they also say it’s not that hard to afford them.

That’s the paradox at the center of a new KFF poll showing the apparent disconnect between public perception of prescription drug prices and the day-to-day realities of actually buying medication.

The results showed that 82% of adults say the cost of prescription drugs is unreasonable. However, 65% say affording their prescriptions is either “very” or “somewhat easy.” The poll did not stratify respondents based on whether they were insured.

Meanwhile, drug prices and affordability are top of mind for the pharma industry and the government right now. Just last month, the Biden administration unveiled the first 10 drugs subject to Medicare price negotiation under the Inflation Reduction Act, which the industry argues will have several detrimental effects, including causing companies to slash R&D investments.

A recent PharmaVoice newsletter reader poll echoes this fear, with 60% of respondents agreeing that the drug pricing provisions in the IRA will seriously harm pharma R&D investments.

However, a report published earlier this year in the medical journal BMJ concluded that drug prices are “not justified” by R&D investments.

Using publicly available financial reports from 1999 to 2018, the researchers found that 15 of the largest biopharmaceutical companies spent $1.4 trillion on R&D. By contrast, those same companies spent significantly more — $2.2 trillion — on costs relating to selling, general and administrative activities.

The public appears just as skeptical as the BMJ authors about the cost of research driving up drug prices. The KFF poll found that 83% of respondents believe that pharma profits are a “major factor” in the price of prescription drugs, compared to just 54% who say the same about R&D.

Needed reforms

The public also supports increased regulation for pharma drug prices, as well as many of the IRA’s key provisions.

Seventy-three percent of respondents in the KFF poll said that there’s “not as much regulation as there should be” when it comes to limiting the price of prescription drugs.

They also overwhelmingly support authorizing the federal government to negotiate the price of some prescription drugs for people with Medicare (81% of respondents); placing an annual limit on out-of-pocket prescription drug costs for people with Medicare (82%); and capping monthly out-of-pocket insulin costs for people with Medicare (84%), all of which are part of the IRA.

Although most people say affording their prescriptions is “easy,” not everyone who took part in the KFF poll had the same experience. Unsurprisingly, affordability was harder for people who take four or more prescription medicines and for those whose annual household incomes are less than $40,000. About 30% of adults said cost was the reason they didn’t take their medication as prescribed at some point in the past year.

According to an HHS report, 9 million Medicare Part D enrollees took at least one of the 10 drugs selected for negotiation and paid a total of $3.4 billion in out-of-pocket costs for them in 2022.  For enrollees without additional financial assistance, average annual out-of-pocket costs for these drugs were as high as $6,497 per enrollee in 2022, the report said.

However, the KFF poll found that adults 65 and older actually had the easiest time affording their medications, with only 25% of respondents in this age group saying it was difficult. In contrast, 33% of 18 to 29-year-olds found it difficult to afford their medications, and this was the age group most likely to say so. This younger group is also the least likely to be insured, according to the CDC.