Data from the Medical Expenditures
Panel Survey, 1997-2015
Lawrenceville,
NJ, USA—August 27, 2019—Value in
Health, the
official journal of ISPOR—the
professional society for health economics and outcomes research, announced today the publication of new research showing that
while expenditures for prescribed medicines have risen significantly in the
United States for the past 2 decades, expanded prescription drug coverage
(including increased public payment since the implementation of Medicare Part D
and the Affordable Care Act) has resulted in a significant reduction in patient
out-of-pocket drug costs. The report, “Per-Prescription
Drug Expenditure by Source of Payment and Income Level in the United States,
1997 to 2015,” was published in the August
2019 issue of Value
in Health.
To evaluate the trend of US prescription drug prices and the
impact of Medicare Part D and the Affordable Care Act on out-of-pocket drug spending
for older and poorer consumers, the authors compared expenditures for
prescription medications and for medical visits over time and examined the
relationship of drug expenditures by source of payment and income level. Data
for the study were extracted from the Medical Expenditures Panel Survey (MEPS), 1997 to 2015.
The cost per prescription increased from $38.56 in 1997 to
$73.34 in 2015. Nevertheless, the study showed that consumers’ out-of-pocket expenditures
decreased from $18.19 to $9.61. Out-of-pocket expenditures of low-income and
near-poor individuals had larger percentage reductions relative to individuals
in higher-income groups before and after implementation of Medicare Part D. While
consumer out-of-pocket costs decreased, public program expenditures per
prescription increased from $5.61 to $34.43. Over 90% prescription purchases
were covered by medical insurance by 2015.
“The results of this study suggest that for many individuals the
cost of obtaining medications has declined owing to the ubiquitous prescription
drug benefits that accompany private and public health insurance,” said
corresponding author Daniel C. Malone, PhD, Department of Pharmacy Practice and
Science, College of Pharmacy, University of Arizona, Arizona, USA. “For the
elderly, disabled, and historically uninsured in the United States,
prescription drugs have become more affordable because of implementation of
Medicare Part D and Affordable Care Act. Indeed, our study suggests that over
the past 2 decades there has been a remarkable shift in medication costs from
consumers to public sources. This has occurred across all income levels, but
especially among low income individuals.”
In the United States, as recently as the late 1980s, most
prescription drugs were purchased directly by patients. Before 2006, older
persons on Medicare constituted one of the largest segments of the US population
lacking insurance for prescription drugs despite consuming more medications
than younger individuals. Likewise, low-income individuals who failed to
qualify for Medicaid also paid out of pocket for medications or went without
treatment. The rapid rise in prescription drug programs has shielded consumers
with private health insurance or Medicaid from part or all of the cost of
medications. The passage of Medicare Part D and the Affordable Care Act has further
shifted direct expenditures for medications from consumers to insurers and
public payers.
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ABOUT ISPOR
ISPOR, the professional society for health economics and outcomes research (HEOR), is an international, multistakeholder, nonprofit dedicated to advancing HEOR excellence to improve decision making for health globally. The Society is the leading source for scientific conferences, peer-reviewed and MEDLINE®-indexed publications, good practices guidance, education, collaboration, and tools/resources in the field.
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ABOUT VALUE IN HEALTH
Value in Health (ISSN 1098-3015) is an international, indexed journal that publishes original research and health policy articles that advance the field of health economics and outcomes research to help healthcare leaders make evidence-based decisions. The journal’s 2018 impact factor score is 5.037. Value in Health is ranked 4th among 81 journals in health policy and services, 5th among 98 journals in healthcare sciences and services, and 11th among 363 journals in economics. Value in Health is a monthly publication that circulates to more than 10,000 readers around the world.
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