Association of Insurance Gains and Losses With Access to Prescription Drugs

The unmet need for prescription drugs doubles among initially insured adults who lose coverage and declines among initially uninsured adults who gain coverage, according to a research letter published Sept. 11 in the JAMA: Internal Medicine.

Using longitudinal data from the nationally representative Medical Expenditure Panel Survey, authors K. Robin Yabroff, PhD, et al., found that among individuals with continuous coverage, the percent with unmet need for prescription drugs was low in the first two years at 3.2 percent and 3.3 percent, respectively. In contrast, among individuals insured in year one but who lost coverage in year two, the percent with unmet need more than doubled, from 3.1 percent to 6.6 percent, over the same period of time. Continuously uninsured individuals experienced an unmet need for prescription drugs at similar percentages in years one and two at 6.2 percent and 5.5 percent, respectively. However, initially uninsured individuals who gained coverage in year two had a 3.4 percentage point decline in unmet need.

Researchers noted declines in unmet need for those gaining insurance were significantly greater than for the continuously uninsured, while increases in unmet need for those losing insurance were significantly greater than for the continuously insured. However, having insurance did not guarantee coverage completeness or access to care. Additionally, researchers highlighted that patient cost sharing is increasing through higher deductibles, copayments and coinsurance rates, and medical financial hardship is increasingly documented in the U.S., especially in relation to prescription drug use.

“Prescription drug spending is projected to continue rising, increasing fiscal pressures on commercial, federal, state and family budgets,” write Yabroff, et al. “For individuals with high drug costs, these trends may erode some of the protective effect of insurance coverage documented in this study. It is therefore imperative that research continue to monitor the relationship between insurance coverage and unmet need, assess spending and clinical outcomes, and that survey, administrative, and clinical data be available to do so.”

Keywords: Deductibles and Coinsurance, Medically Uninsured, Health Expenditures, Prescription Drugs, Drug Costs, Research Personnel, American Medical Association, Insurance Coverage, Cost Sharing

< Back to Listings