Prescription Drug Insurance Out of Reach for Many Older Adults


Lower household income and requiring multiple medications play large roles

While only 5% of older adults lacked prescription drug coverage in 2021 – down from 32% in 1998 – 20% reported financial hardship from prescription drug purchases, according to a study.

Those without prescription drug insurance, requiring multiple daily medications, and reporting a low annual household income struggled the most. Even those with insurance from lower income households still struggled when needing multiple daily medications.

The researchers said that among older adults in the United States, policies that reduce the out-of-pocket expenditures for prescription drugs appeared to reduce the burden of these expenditures, and suggest that managed care policymakers should consider policies that reduce out-of-pocket costs for older adults in an effort to promote medication access. Such policies may enable older adults to reallocate funds for vital expenses like food and shelter, especially for older adults from vulnerable populations.

The report states that the inability to pay for prescription drugs is an important determinant of medication adherence that may lead patients to ration or split doses, delay refills or new prescriptions, and even stop taking medications altogether. Cost-related nonadherence compromises the therapeutic effectiveness in managing most chronic diseases, persists even when patients cut back on basic health-related social needs, and consequently leads to higher preventable health care expenditures.

The data were from four nationally distributed, cross-sectional surveys of older adults to track coverage for and financial hardship from purchasing prescription drugs.

This article originally appeared on Medical Economics.


Olson A, Schommer JC, Mott DA, Adekunle O, Brown LM. Financial hardship from purchasing prescription drugs among older adults in the United States before, during, and after the Medicare Part D “Donut Hole”: Findings from 1998, 2001, 2015, and 2021. J Manag Care Spec Pharm. 2022 May;28(5):508-517. doi: 10.18553/jmcp.2022.28.5.508.

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