Customer Attitudes Around Prescription Drug Pricing and the Role of Pharmacy Benefit Managers

The costs for prescription drugs keep rising, which puts pressures on the wallets of Americans, and more importantly has a potentially devastating impact on our health. Recent reports have found that 1 out of every 3 Americans are unable to afford to take their medication as prescribed, which echoes the latest research from Navitus Health Solutions, which recently polled 2,000 Americans on their attitudes around drug pricing and awareness of the issues impacting pricing. Notably, 48% reported that the price of medication had affected their ability to get a medicine they needed at least once. 

Across the board, the survey unveiled that a surprising number of Americans struggle to pay for the medications they need to stay healthy. Surprising findings included: 

HOW AMERICANS ARE COPING WITH RISING DRUG COSTS

Recent research found that Americans pay, on average, 2.8 times more for prescription drugs than the 33 other countries studies, and 4.2 times more for the larger name-brand drugs. To manage these rising drug costs, Americans are taking things into their own hands to get access to biosimilars and other lower cost medication.

UNDERSTANDING THE COST-MITIGATING FACTORS

Due to these unsustainable rising costs, 88% of Americans stated they believe prescription drug pricing should be a priority for the next administration, and 42% wanted more transparency around lower cost options that are available. However, the survey results, across the board, revealed that Americans are largely unaware of one of the biggest factors impacting drug pricing — pharmacy benefit managers (PBMs).

Over 275 million Americans are served by a PBM, which act as intermediaries in the healthcare system designed to help negotiate discounts and pricing with drug manufacturers. Despite PBMs’ direct influence on drug pricing, the survey found that:

“Despite all recent negative media attention around traditional PBMs, which fill 94% of prescriptions in the U.S., the average American isn’t aware of how these companies operate,” said David Fields, CEO of Navitus Health Solutions. “The traditional PBM model generates profit by creating margin within the drug supply chain. Consumers are commonly unaware and uninformed about the impact of those actions on prescription drug prices accessed through their insurance. American healthcare consumers want lower prices. Healthcare consumers and political leaders want transparency. Innovation to this end is what the Navitus PBM has championed for over twenty years. Not all PBMs are alike. Ours is meaningfully driving lower cost and enabling transparent drug pricing while others are continuing to conspire to keep drug prices high for their benefit. “

AMERICANS TO PLAY AN INCREASING ROLE IN ADVOCATING FOR LOWER PRICES

“While more consumer awareness around the role PBMs play in prescription drug pricing is vital for real change, I think it’s promising that the majority of respondents understand the variable nature of prescription pricing,” said Sharon Faust, Chief Pharmacy Officer at Navitus Health Solutions.

“People are looking for more transparency and are open to biosimilars and lower cost options,” said Sharon. “If you are concerned about the cost of medication, speak up. Not just to your doctor or pharmacist, but also to your benefits manager if you receive healthcare through an employer.”

SURVEY METHODOLOGY

The data was derived from a survey by Navitus Health Solutions conducted online via Pollfish on October 2, 2024. 2,000 Americans aged 18+ completed the survey.

Of the respondents, 56% identified as female and 43% as male. 93% reported having medical insurance. All decimals in this report are rounded to the nearest percentage point, which may lead to certain numerical totals adding up to slightly more or less than 100%.