31% of Americans Paying for Prescriptions Say They’re a Financial Strain, but Many Don’t Take Advantage of Ways To Lower Costs

With food prices remaining high and housing costs ever-expensive, simply existing can take a major financial toll.

That’s particularly true for Americans who need medication. According to the latest ValuePenguin survey of more than 1,900 Americans, 31% of consumers who pay for at least a portion of their prescriptions say those expenses are a financial strain. And that figure rises to 41% among those with ongoing major medical issues.

Here’s what else we found.

Key findings

Americans who pay for at least a portion of their prescriptions say they’re a financial strain

Of the 64% of Americans who take prescription medication, just 50% say insurance covers the full cost.

According to ValuePenguin health insurance expert Divya Sangameshwar, that’s not surprising — particularly because another ValuePenguin study found that 55.7% of American private sector workers were enrolled in high-deductible health plans (HDHPs) in 2021. That’s the highest on record (dating to 2012) and the eighth straight yearly increase.

By age group, millennials ages 27 to 42 are the most likely to say their insurance fully covers the cost of their medication at 58%. That compares with:

Perhaps due to Medicaid qualifications, those making less than $35,000 are the most likely income group to say their prescription costs are fully covered at 61%. Comparatively, just 41% of those making between $50,000 and $74,999 say similarly — the lowest by income group. Additionally, men (57%) are more likely to say their medications are fully covered than women (44%).

For those who have to pay at least part of their prescriptions, those costs are often a burden. Among this group, 31% say paying for their medication is a financial strain. That’s particularly true among millennials at 43%. Meanwhile, just 19% of baby boomers say similarly.

Those with ongoing major medical issues (41%) are more likely to say medication costs are a financial strain. On the other hand, 27% of those with some minor health issues and 19% of those with no medical issues feel that financial strain.

How much, exactly, are consumers spending on medication? While the majority (69%) say they spend $99 or less a month on their prescriptions, over a quarter (26%) say they spend between $100 and $499 monthly. Breaking this down even further:

It’s also worth noting that Americans with major health conditions are less likely to say they only keep their prescription spending in the double digits. Of this group, 54% say they spend $99 or less monthly on medications — significantly less than the 81% of Americans with no health conditions and 71% of Americans with minor health conditions who say similarly.

Majority of Americans rely on prescriptions — regardless of health status

Overall, 64% of Americans have at least one prescription medication, with 39% saying they have multiple. Unsurprisingly, 96% of those with serious or chronic health issues have a prescription (highest of any group) — 79% of whom rely on multiple medications.

Even Americans with minor or no health concerns rely on prescriptions. In fact, 80% of Americans with minor health conditions and 35% of Americans with no health concerns say they have at least one prescription.

But what if those prescriptions aren’t exactly conventional? With diabetic medications like Ozempic increasingly being prescribed for off-label uses like weight loss, it may not be surprising that 23% of Americans say they got a drug prescribed to them for off-label use. That figure’s common among:

Among the Americans who say they got a drug prescribed to them for off-label use, 73% say their insurer covered its use. Perhaps as a result of this, 83% say they were able to afford their off-label prescription.

17% have gone into debt to afford their family’s prescriptions

Health insurance may be more accessible due to the Affordable Care Act, but health plans don’t always fully cover prescription costs. Of those without full prescription coverage, 90% say their insurer covers part of their prescription costs — but 10% are on the hook to pay full retail prices.

With that burden in mind, it’s worth noting that 17% have gone into debt to afford their family’s prescriptions. That figure rises to 28% among those with children younger than 18 — significantly higher than the 11% of Americans with adult children and 10% of those without children who say similarly.

By health status, those with some ongoing major medical issues (28%) and those with serious or chronic medical issues (24%) are the most likely to go into debt for prescription costs. That compares with 17% of those with minor issues and 12% with no major issues.

Meanwhile, millennials (25%) are the most likely age group to go into debt for family prescription costs. That stacks up against:

Additionally, men (23%) are more likely to have taken on prescription debt than women (12%).

Nearly a third of Americans have skipped filling a prescription because they couldn’t afford it

For many Americans, the costs of prescriptions aren’t only a financial burden — sometimes they’re a health burden, too. In fact, 31% of Americans have skipped filling a prescription they needed, mainly because they couldn’t afford it (37%) or their insurance wouldn’t cover the cost (25%).

Although skipping a prescription might seem financially necessary, Sangameshwar says it’s extremely risky.

By health status, those with serious or chronic health conditions are the most likely to say they skipped filling a prescription at 45%. That’s followed by those with some ongoing health issues (44%) and those with minor health issues (34%).

Meanwhile, millennials (42%) are the most likely age group to skip filling a prescription. That compares with:

Those with underage children (42%) are significantly more likely to say they’ve skipped a prescription than those without children (25%) and those with children older than 18 (21%). Meanwhile, six-figure earners and those making between $35,000 and $49,999 are the most likely income group to say they’ve skipped filling a medication before at 34% each. In contrast, 26% of those making between $50,000 and $74,999 say similarly.

Online pharmacies help save money, but only 31% have used them

In an increasingly online world, it’s not surprising that many pharmacies now operate digitally, too — but consumers may be wary of them. In fact, just 31% of Americans have used an online pharmacy. That figure’s highest among six-figure earners (53%), parents with children younger than 18 (42%) and men (40%).

By age group, millennials (39%) are most likely to use online pharmacies — significantly higher than the 26% of Gen Xers and baby boomers who say similarly (tying for the next highest age group).

Why aren’t more Americans utilizing online pharmacies? According to Sangameshwar, the hassle of switching and potentially long shipping times may play a role — though the risks of moving to an online pharmacy may also be to blame.

"Americans considering a switch to an online pharmacy should do their due diligence before making the switch," she says. "This includes working with an online pharmacy that requires a doctor’s prescription for medications, has a physical address and phone number in the U.S., is licensed to operate in the state they’re in and has a licensed pharmacist on staff to answer questions. Your insurer would have this information, so a good place to start your research would be with them. Your insurer will also help you find out if the online pharmacy is in their network."

Still, those who have utilized online pharmacies say they’ve noticed the benefits. Of those who’ve taken their prescriptions to online pharmacists, 78% say their insurance covered it. That’s particularly true among baby boomers (83%) and six-figure earners (83%). Meanwhile, 81% say it was cheaper, a figure that’s high among six-figure earners (86%) and adults with underage children (86%). It’s also worth noting that men (86%) are significantly more likely to say online pharmacy costs are cheaper than women (74%).

This comes as just 33% of Americans say they’ve switched pharmacies to take advantage of lower costs (though more on that below).

Majority of Americans aren’t using common cost-saving measures

Paying for medications may be a financial burden, but there are many ways to cut costs — though the majority of Americans haven’t explored most cost-cutting measures. In fact, 79% of Americans without full coverage haven’t negotiated the cost of a prescription with their insurer. Meanwhile, 75% haven’t contacted the drug manufacturer about pharmaceutical assistance programs and 56% have never asked their health care provider for alternative prescriptions covered by their insurance.

Additionally, 62% of Americans have never used coupons to save on prescription costs or websites to track related costs.

By age group, millennials who pay for their prescriptions are most likely to try cutting costs. They’re particularly likely to ask their health care provider for alternative medications that their insurance covers (53%) and negotiate the cost of prescriptions with their insurer (38%). Millennials overall (regardless of whether they pay for their prescriptions) are also most likely to use coupons, at 49%.

Meanwhile, those with kids younger than 18 who pay for their prescriptions are particularly likely to ask their health care provider for alternatives (57%) and ask the drug manufacturer about pharmaceutical assistance programs (39%).

While Americans with major and serious health conditions are more likely to be aware of strategies to save money on their prescriptions, the levels of awareness vary by the type of strategies they employ — and, Sangameshwar says, aren’t as high as they should be. To break that down:

Struggling to afford medication? Here’s what experts recommend

Medication is expensive, but skipping a prescription — while an understandable thought — is often unnecessarily dangerous.

"High prescription drug prices are forcing many Americans to make difficult and sometimes troubling choices, such as skipping their prescriptions because they can’t afford them," Sangameshwar says. "But that’s a drastic and dangerous choice, especially when Americans can employ many other strategies to reduce the cost of their prescriptions."

To help lower costs, she recommends the following: