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​Millions of Older Americans Can't Afford Their Prescriptions

​New report finds Blacks, Latinos more likely to have problems paying for medications

couple going over their medicines at home

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A new federal report says that 3.5 million Americans age 65 and older struggled to afford their needed prescription drugs in 2019 and that Medicare beneficiaries of color and those with lower incomes were more likely to skip needed doses because of cost.

The report from the Office of Health Policy at the U.S. Department of Health and Human Services (HHS) is based on the annual National Health Interview Survey. The report also looked at Medicare beneficiaries under 65 and found that 1.8 million of those enrollees had problems affording their medications in 2019. Individuals under 65 with disabilities may qualify for Medicare.

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Federal officials said they used the 2019 rather than the 2020 national survey because they were concerned that the COVID-19 pandemic may have affected prescription drug use and other survey responses.

"The high cost and out-of-pocket expenses of drugs cause many Americans — particularly those with chronic conditions such as diabetes — to delay or skip taking needed treatments," the report says. This despite the fact that the vast majority of Medicare beneficiaries have prescription drug coverage.

AARP is waging a Fair Rx Prices Now campaign to lower the cost of prescription drugs, advocating measures that would allow Medicare to negotiate prices with pharmaceutical companies, cap out-of-pocket costs for Medicare Part D enrollees and penalize drugmakers for raising prices more than the rate of inflation. "As prices rise, more and more seniors and patients are forced to make difficult choices between filling their prescriptions or paying rent and buying groceries," Nancy LeaMond, AARP's executive vice president and chief advocacy and engagement officer, said in a Jan. 4 letter to U.S. senators urging them to take immediate action on these priorities to lower drug prices.

In a 2021 AARP survey of registered voters age 50 and older, nearly one-fifth (19 percent) said they had not filled a doctor's prescription in the past two years, with the most common reason being that they could not pay for it.​

Included in the Build Back Better legislation that the U.S. House of Representatives passed in November, 2021 were the changes AARP championed, including Medicare negotiation of prescription drugs, a $2,000 annual cap on out-of-pocket Part D prescription drug plan costs and tax penalties for drugmakers who raise prices higher than inflation.

"It’s now been two months since that critical vote and Congress has yet to finish the job and bring down the outrageous prices of prescription drugs," LeaMond said in a Jan. 20 statement. "Older Americans are sick and tired of paying drug prices that are three times higher than the rest of the world, and broken promises to provide relief for medicines they cannot afford. There is no reason Congress can’t get this done, and every reason to deliver."

Some key findings of the HHS report:

  • ​​Black and Latino adults age 65 and older were 1.5 to 2 times more likely to have trouble affording their prescriptions than white adults.

  • Among adults with diabetes, 9.9 percent of those 65 and older and 26.2 percent of Medicare beneficiaries younger than 65 experienced affordability problems, compared with 6.6 percent and 22.7 percent, respectively, for those age groups as a whole. 

  • 7.8 percent of women and 5.2 percent of men reported affordability problems.

  • 11.1 percent of those with incomes below 200 percent of the federal poverty level ($33,820 for a family of two in 2019) reported having trouble affording medications, compared with 4.7 percent of those with incomes above 200 percent.

Dena Bunis covers Medicare, health care, health policy and Congress. She also writes the “Medicare Made Easy” column for the AARP Bulletin. An award-winning journalist, Bunis spent decades working for metropolitan daily newspapers, including as Washington bureau chief for the Orange County Register and as a health policy and workplace writer for Newsday.

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