Healthcare

The Average American Spends This Much on Prescription Drugs Each Year — The Motley Fool

Here’s how much the average American spends on prescription drugs Based on the company’s findings from 2013 through 2014, among 31.5 million insured Americans, the average American’s annual prescription drug tab is $1,370. Since insurance does help to cover some (or all) of the cost of prescription drugs, the average out-of-pocket expenses for these insured members ended up being only $185. Put another way, the average American had to cover 14% of the cost of their prescription medicines from 2013 through 2014.

Source: The Average American Spends This Much on Prescription Drugs Each Year — The Motley Fool

Bernie Sanders claims 20% of Americans can’t afford their prescriptions which is curious given that the uninsured rate is currently about 11%. Prescription drugs are an essential health benefit mandated by the ACA.

The fact is most Americans have coverage for their prescriptions and the lower-income have additional coverage to help pay out-of-pocket costs.

ObamaCare’s Cost Sharing Reduction Subsidies (CSR) lower out-of-pocket costs, based on income, for Silver plans bought on the Health Insurance Marketplace.

hands_pouring_out_pills_lg_nwmClearly we need to rethink the entire process surrounding prescription drugs from initial research to advertising. There are things that don’t work well from start to finish. However, the political hype about drugs is not helpful. Few people pay the headline retail price for a drug. Most Americans are paying a co-insurance or co-pay based on a discounted price.

Whatever we seek to change let’s not forget there are consequences. You simply cannot pay much less for prescriptions without giving up something. The much touted VA for example lowers costs by using a very limited formulary. In other words you can only receive a certain drug within a class of drugs. They do that because by concentrating volume with one drug company they can get a bigger discount. Your private plan does something similar except you typically have the option of another drug if you pay more.

Keep in mind the more choices we have, want and demand in our health care, the more it will cost.

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1 reply »

  1. There has to be more to it than that. A guy at work who makes 6 figures, called the drug company and they are paying the first $12k of his $20k/yr drugs all because he called. They are going to pay directly to Express Scripts in his name and it will count toward his out of pocket expenses.

    Now the questions are, why is the drug over priced by $12k if they can afford to discount it and why isn’t Express Scripts getting this savings for the patient and the employer? If he does not call and apply every year he looses that discount or rebate or whatever they call it.

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