Access to, and levels of spending on, prescription drugs has become an important public policy issue.  Given the significant individual and population health gains that result from the appropriate use of prescription drugs, as well as the fiscal concerns pertaining to the escalation of health care expenditures, the development and implementation of patient-centered solutions that allow access to medications at an affordable cost are of critical importance.

One common strategy that health care purchasers employ to control pharmaceutical spending is to increase consumer cost-sharing.  This trend — seen for nearly all drugs across all formulary tiers — has proceeded regardless of the clinical benefit provided by a specific drug, with cost-sharing increasing as rapidly for high-value drugs (e.g., included in evidence-based guidelines) as for drugs deemed unnecessary or potentially harmful.

¹  As consumers are asked to pay a greater proportion of their medication expenses, cost-related non-adherence is an important and growing problem.  A robust body of peer-reviewed evidence demonstrates that cost-related non-adherence exists for high-value medical services across the entire episode of clinical care, including clinician visits, diagnostic tests, and especially prescription medications.²³⁴  Nearly one in five insured adults report going without needed care due to cost.⁵  Sub-optimal use of evidence-based services results in poor patient-centered outcomes and, in some scenarios, higher expenditures for both the patient and the third-party payer.

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