Millions of seniors can’t afford their prescription medications: Study

(NEW YORK) — Millions of American seniors are having a hard time affording their prescription medications, a new National Health Statistics report suggests.

The study, published by the Centers for Disease Control and Prevention, found that approximately 4% of those aged 65 and older can’t afford their prescription at all, and more than 3% of them skipped doses, delayed filling a prescription or took less medication than prescribed to cut back on costs.

“Older adults that were food insecure were six times more likely to not get their prescription medication,” Robin A. Cohen, study co-author and statistician with the CDC’s National Center for Health Statistics, said.

Dr. Lalita Abhyankar, a family medicine physician based in San Francisco, told ABC News she often sees patients struggling to pay for their medications.

One of Abhyankar’s patients with diabetes couldn’t afford his monthly dose of insulin, so “he would ration out his insulin,” she said. Despite being on both Medicaid and Medicare, “the copay was challenging for him to do on a month-to-month basis,” she noted.

Abhyankar has also seen this problem when patients needed an expensive medication because cheaper alternatives haven’t worked.

“I’ve seen them do half a dose or take it once a day instead of the recommended twice or three times a day and then continue to walk around with uncontrolled high blood pressure,” Abhyankar said. “That increases their risk of stroke, heart attack, damage to the eyes and kidneys.”

She went on, “The downstream effects are going to be that we’re going to see more patients in hospitals, and emergency rooms. That puts a huge burden on the healthcare system.”

Generally, adults aged 65 and older qualify for universal health care under Medicare. That covers medical needs such as doctors’ visits and hospital stays.

Medications aren’t automatically included. Older adults must enroll in Medicare Part D, a separate prescription drug coverage plan, or a private insurance plan that helps pay for medications.

Even when they are covered, most Americans will still owe some amount for copays and premiums. When the expenses pile up, some choose to forego any coverage at all.

Abhyankar said there are ways to reduce the cost of prescriptions including websites such as GoodRx that can offer coupons for customers sometimes at lower prices. Another option is the online discount pharmacy Cost Plus Drugs, which has hundreds of medications available for purchase at lower prices.

Abhyankar also suggested that patients try insurance preferred pharmacy programs, which are pharmacies that have an agreement with an insurance plan to charge less to fill prescriptions.

Last month, the Biden administration announced an agreement with drug companies to lower the price of 10 prescription medications for people with Medicare Part D. The negotiated prices will go into effect on Jan. 1, 2026.

Roshan Nebhrajani Bransden, MD, is a family medicine resident physician and a member of the ABC News Medical Unit.

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