OBJECTIVES: The US healthcare spending per capita exceeds all other nations, and the high costs of brand-name and generic prescription medications are significant contributors. Understanding how the American public feels regarding drug affordability can inform future healthcare policy. The objectives of this study were to assess the perception of drug affordability and pricing in the US general population and how these perceptions vary between respondent sub-groups.

METHODS: A survey was administered to the US general population as a part of the US EQ-5D-5L face-to-face valuation study and online experimental study; survey questions were held constant between modes of administration. Quota sampling was used to obtain a sample representative of the overall, adult US population in terms of age, gender, ethnicity, and race. Additional respondent characteristics assessed included medication use, education attainment, ability to pay bills, health literacy, self-reported health, medication use, and opinions regarding US healthcare issues. Respondent characteristics hypothesized to be associated with perception of prescription pricing were evaluated in bivariate analysis (significant if p-value<0.05) and used as independent variables in multivariable logistic regression; predictors were considered significant if p-value<0.10.

RESULTS: Overall, 71.8% of respondents considered the cost of drugs in the US to be unreasonable; interestingly, 74.8% of respondents who regularly took at least 1 prescription report somewhat easily or very easily affording their medications. More females believed US drug costs were unreasonable as compared to males (76.6% and 66.7%, respectively). In a multivariable logistic regression, age, gender, race, overall health, insurance status, and education attainment were significant predictors of drug pricing opinion.

CONCLUSIONS: Much of the general population finds US drug pricing to be unreasonable. A range of sociodemographic respondent characteristics are associated with respondent perception of drug pricing reasonability. Further analyses are needed to describe population attitudes toward drug affordability and pricing in greater detail.