Prescription drug expenditures are highest for people age 65 and older. Drug expen-ditures are particularly high for the oldest adults. For example, average annual prescription drug expenditures for people age 80 and older are almost 1. People age 80 and older pay even more see Figure 4. Adults pay almost half — 48 percent — of their expenses for prescription drugs out-of-pocket, but persons age 65 to 79 pay 56 percent and those age 80 and older pay 67 percent of their total drug expenditures out-of-pocket.
Consumers who have common chronic conditions have substantial prescription drug expenses. Since their total prescription drug expenditures are very high, their total out-of-pocket expenditures are also high. They pay about half of the cost of prescription drugs out-of-pocket.
Some people take less medication than prescribed because of the cost. This is a particular problem for more vulnerable populations. For example, among adults who report poor health, about one-fourth percent — of people age 51 to 64 and more than one-tenth — 12 percent — of people age 65 and older say that they have taken less medication than prescribed in the past two years because of the cost.
Substantial proportions of people with common chronic conditions also report that because of cost they take less than the prescribed amount of medication see Figure 6.
The practice of taking less medication than prescribed may increase overall health care costs if the result is more emergency room visits, hospital admissions, or physician visits. A study of people age 65 and older in eight states reports that a substantial proportion of people, in particular those with low incomes, take less medicine than prescribed.
For example, 22 percent of respondents indicate that they had not filled prescriptions one or more times in the past year because of the cost. Some 23 percent say they skipped doses of medication to make it last longer. A substantial proportion of respondents — 21 percent — report that they spent less in the past year on food, heat, or other necessities so they could afford to purchase their medications. The Medicaid program plays an important role in providing prescription drugs for a particularly vulnerable population.
All Medicaid beneficiaries have very low incomes and almost one-third report fair or poor health status. Nationally, Medicaid covers 60 percent of prescription drug expenditures, but beneficiaries still must pay about one-third of the cost out-of-pocket. Because the program is state administered, the extent of Medicaid prescription drug coverage varies considerably among states, however.
Medicare beneficiaries pay a much higher proportion of drug expenditures — 62 percent — out-of-pocket see Figure 7. For both the uninsured population and Medicare beneficiaries without prescription drug coverage, out-of-pocket drug expenditures may be high if they must pay the full retail price at the pharmacy. The Medicaid program is a significant part of state budgets.
Over the past several years, Medicaid spending has grown. Spending on prescription drugs is one factor that has contributed to growth in Medicaid spending. Medicaid spending on prescription drugs grew, on average, by 18 percent between and As states struggle to balance budgets, many have adopted policies to control Medicaid spending for prescription drugs. More than half of states report changes in Medicaid prescription drug policies for fiscal year Many states are negotiating for larger discounts and rebates on their prescription purchases.
Another popular strategy is to place some limits on the types of drugs that can be prescribed by requiring prior authorization for prescriptions, using a preferred drug list, or requiring that generic drugs be prescribed.
Some policy changes may have a more immediate effect on beneficiaries. Chart 1 Prescriptions in Millions and Growth. Chart 9 Generic Shares of Dispensed Prescriptions. Chart 13 Retail Dispensed Prescriptions for Opioids. Chart 14 Total Spending on Medicines and Growth. Chart 20 Impact of Biosimilars. Chart 23 Average Initial Cost Exposure. Chart 27 Total Spending on Medicines. Chart 37 Morphine Equivalency Segments and Factors.
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OK Open in a new tab. The overall number of prescription items dispensed in the community in England in was 1. This was an increase of 0. The report includes the ten most prescribed drugs in by cost. National Statistics status means that official statistics meet the highest standards of trustworthiness, quality and public value. This release is subject to a further assessment by the OSR over the next few months.
There are many costs involved in the dispensing of a prescription item by a dispensing contractor. The costs displayed in this publication are the amount that would be paid using the basic price of the prescribed drug or appliance and the quantity prescribed. The basic price is given either in the Drug Tariff or is determined from prices published by manufacturers, wholesalers or suppliers. Basic price is set out in Parts 8 and 9 of the Drug Tariff.
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