Study Finds Millions of Seniors Can’t Afford Prescription Medications

Millions of seniors in the United States are facing challenges in affording their prescription medications, as highlighted in a recent report by the National Health Statistics. This study, conducted by the Centers for Disease Control and Prevention (CDC), reveals that nearly 4% of individuals aged 65 and older are unable to afford their prescriptions. Furthermore, over 3% of these seniors have resorted to skipping doses, delaying prescription fills, or taking less medication than what is prescribed to manage their expenses.

Robin A. Cohen, a statistician at the CDC’s National Center for Health Statistics and a co-author of the study, notes that older adults facing food insecurity are six times more likely to not obtain their required medications. This alarming statistic sheds light on the intersection of financial stability and health access among the elderly population.

Dr. Lalita Abhyankar, a family medicine physician from San Francisco, frequently encounters patients struggling to pay for their necessary prescriptions. One particular patient with diabetes faced the difficult decision of rationing his insulin due to unaffordable copays. Although he was enrolled in both Medicaid and Medicare, he found the monthly out-of-pocket costs to be a significant burden.

Dr. Abhyankar has also observed patients who are required to take expensive medications that are not covered by cheaper alternatives. In many cases, patients might take half doses or change their prescription regimen from two to three times daily to just once a day, ultimately resulting in uncontrolled health conditions such as hypertension. This, she warns, could lead to serious health complications, including strokes or heart attacks, as well as damage to vital organs such as the kidneys and eyes.

She articulated a concern that the broader impact of these issues will lead to increased hospital visits and a greater burden on the healthcare system overall. Although adults aged 65 and older qualify for Medicare, which covers a significant portion of healthcare needs including doctor visits and hospital care, prescription medications do not automatically fall under this coverage. Seniors must enroll in Medicare Part D, a distinct prescription drug plan, or obtain private insurance to assist with their medication costs.

Even with enrollment in Medicare, many older adults still face copays and premiums that can pile up, leading some to forgo prescriptions entirely. Dr. Abhyankar suggests several strategies for reducing medication costs. Websites like GoodRx provide coupons that can sometimes lower prescription prices significantly. Another viable option includes using the online discount pharmacy Cost Plus Drugs, which offers hundreds of medications at reduced prices.

Furthermore, Dr. Abhyankar recommends patients look into insurance preferred pharmacy programs. These programs are agreements between certain pharmacies and insurance plans, allowing patients to fill prescriptions at lower costs compared to standard prices.

In a recent development, the Biden administration announced a partnership with pharmaceutical companies to negotiate the prices of ten specific medications for seniors enrolled in Medicare Part D. These negotiated prices are set to take effect on January 1, 2026, aiming to alleviate some of the financial burdens faced by older adults in accessing essential medications.

The difficulties faced by seniors in affording their prescriptions highlight an urgent need for systemic changes and more comprehensive coverage options to ensure that the health and wellbeing of this vulnerable population are adequately prioritized.

Source: ABC News