Nearly a third of Americans aren't filling their prescriptions because of high costs

According to the GoodRx survey, 33% of Americans (52 million if extrapolated to the general population) had a prescription sent to the pharmacy that was ultimately not filled. So why aren't people filling these prescriptions? Medication cost is the main reason. People also forget to pick up their medications. Timing is another big issue. When people do go to the pharmacy, their medication may be out of stock. And many people just can't get to the pharmacy in time. 

This finding is alarming given that nonadherence, or not taking a medication as prescribed, can worsen chronic conditions. The high cost of medications can force people to make difficult choices between prioritizing their health and managing other essential expenses. In turn, this can lead to poor health outcomes and increased costs in the long run.

Medication cost is the leading cause of unfilled prescriptions in the U.S. And this is an issue that affects people with and without health insurance. In fact, nearly a quarter of Americans are unable to fill their medication because their insurance doesn't cover it. 

When insurance doesn't cover a medication, patients are often on the hook for the full price. They may face financial strain and, ultimately, gaps in treatment and worsening symptoms. 

As it turns out, individuals who rely on the Affordable Care Act health exchange insurance plans have poorer coverage compared to other plan types. Among those on health exchange plans, 34% report a lack of prescription coverage. People with Tricare, Veterans Affairs (VA) insurance, or other military insurance have the highest rates of prescription coverage.

GoodRx Research found that 23% of people spent more than $50 on their prescriptions per month (after removing respondents with Medicaid coverage). And nearly 10% reported spending over $100 on their prescriptions in the most recent month.

And, once again, people with a health exchange plan, no insurance, or private insurance seem to pay more out of pocket on their prescriptions each month.

Costs vary a lot for people with exchange plans. Only 19.7% pay nothing out of pocket and 2.9% pay $200 or more per month. This group, along with those enrolled in private insurance, appear to have the worst coverage for prescription medications. A substantial portion of their out-of-pocket costs falls into the mid-to-high cost brackets. Medicaid recipients, on the other hand, appear to have the most comprehensive prescription coverage. 

This finding is a reminder that prescription affordability will remain a barrier to medication adherence concern for many Americans until costs come down or insurance coverage improves.

Research shows that patients want to talk about cost with their physicians, but few are actually doing so. The GoodRx survey of American adults found that only 42% were having these conversations. And given that cost is a barrier to filling prescriptions, cost conversations should happen every time medications are prescribed.

While some Americans can't afford their medications, 26% can't access their medication at all due to shortages. Among the drugs that people are struggling to access are Ozempic, Trulicity, Zepbound, Mounjaro, Losartan, Adderall, and some antibiotics. 

Factors contributing to shortages may include increased demand, supply chain issues, and manufacturing delays. 

Methodology

The survey was run through YouGov, in three waves. The survey ran monthly from February 2024 through January 2025. In each wave, GoodRx collected 1,000 responses. Survey responses were weighted to the U.S. population using age, gender, race, political affiliation, and education level. The YouGov survey research arm provides more information. To estimate the number of Americans who left a prescription at the pharmacy each month, the survey's incidence rate was multiplied by the percentage of respondents who reported leaving at least one prescription at the pharmacy. This product was then multiplied by the total number of American adults, based on data from the 2019 American Community Survey.