2015 Survey on Prescription Drugs · • While most 50+ adults think that pharmaceutical companies spend too much money on advertising to patients and health care professionals, less

AARP Research | aarp.org/research | Copyright 2016 AARP, All Rights Reserved

2015 Survey on Prescription Drugs AARP Research January 26, 2016 (For media inquiries, contact Gregory Phillips at 202-434-2544 or [email protected])

https://doi.org/10.26419/res.00122.001


Objectives • To understand consumers’ prescription drug use

and opinions regarding cost.

• To learn what struggles, if any, consumers face with regard to the cost of their prescription drugs.

• To gain insight into the views of 50+ adults on the regulations in place for prescription drugs and pharmaceutical companies, the influence they perceive the drug companies have over politicians and health care professionals, and what can be done to control the costs of the drugs.

2


Methodology • An online survey fielded December 1-11, 2015

among a nationally representative sample of 1,834 adults age 50+.

• Additional interviews conducted to reach: – 400 Hispanic/Latino adults age 50+ – 405 African-American adults age 50+.

• The data was weighted by age, gender, race, ethnicity, education, Census region, metropolitan status, household income, and primary language (Hispanics/Latinos only).

• The margin of error for the national sample of 1,834 adults age 50+ is +/- 2.8%. The margin of error among subgroups is higher.

• Percentages may not equal 100% due to rounding.

3


Summary of Key Findings (continued) • Three-quarters of 50+ adults take prescription medication on a regular basis, the percentage is even

higher for seniors. • Overall, among adults who take prescription medications regularly:

– Over eight in ten take at least two drugs – More than half of seniors take four or more drugs – African-American/Black adults and adults with less education and income also take more

prescription medications. • Nearly three in ten say their out-of-pocket prescription drug costs are increasing and the monthly

expenditure for one-third is $50 or more. • For those who say their out-of-pocket drug costs are increasing, most say it is due to changes in their

prescription drug coverage. • Most 50+ adults think prescription drugs are too expensive and most say it is important for politicians

to support efforts to make prescription drugs more affordable. • Over four in ten 50+ adults are concerned about being able to afford their medication. More adults

with lower incomes and lower levels of education are concerned about affording their medication. • Adults age 50-64 are struggling more than seniors to pay for their prescription drugs:

– More than one-quarter have decided not to fill a prescription in the last two years compared to one in six seniors; overall, the predominant reason was the cost of the drug.

– A higher proportion report facing difficult decisions when buying prescription drugs compared to seniors (e.g., delayed filling a prescription or not filled a prescription due to cost, taken less medication to make it last longer, and skipped a dose to save money).

– Nearly half are concerned about being able to afford their medication in the next two years compared to just over four in ten seniors.

4


Summary of Key Findings (concluded)

• Over half of 50+ adults believe that drug companies have a lot of influence over Congress/state legislatures and health care professionals but just over one-third believe they have influence over their own health care professional.

• 50+ adults want more regulation. Three-quarters of 50+ adults think there is not enough regulation when it comes to limiting the price of prescription drugs. Over four in ten think there is not enough regulation when it comes to making sure statements about prescription drugs are accurate and half think there is not enough regulation making sure prescription drugs are safe.

• While most 50+ adults think that pharmaceutical companies spend too much money on advertising to patients and health care professionals, less than half of African-American/Black 50+ adults feel this way.

• Over eight in ten 50+ adults think that drug companies make too much profit and that they should be required to publicly explain how they price their products.

• A large majority of 50+ adults say it should be legal to buy prescription drugs in Canada and Europe.

• Over nine in ten 50+ adults support allowing Medicare to negotiate for lower drug prices. • Over eight in ten oppose the efforts of drug companies to delay the availability of lower-

cost generic substitutes.

5


Use and Cost of Prescription Drugs

6


Three-quarters of 50+ adults regularly take prescription medications and over four in ten(43%) take four or more medications.

17%

39%

23% 20%

1 PrescriptionMedication

2-3 PrescriptionMedications


6+ PrescriptionMedications

0%

20%

40%

60%

80%

100%

Q1: Are you currently taking prescription medications on a regular basis, i.e. daily, weekly, monthly? Q2: Approximately how many different prescription medications do you take on a regular basis?

7

75% of 50+ adults say they take prescription

medications on a regular basis.


Not unexpectedly, over eight in ten (86%) seniors regularly take prescription medications compared to two-thirds (67%) of younger adults. Additionally, more than half (53%) of seniors take four or more regular medications compared to one-third (34%) of younger adults.

22%

43%

18% 16% 12%

35% 29%

24%

1 PrescriptionMedication



6+ PrescriptionMedications

0%

20%

40%

60%

80%

100%

50-64 65+


8

86% of seniors take prescription medications on a regular basis compared to

67% of adults 50-64


Minority populations, lower income and less educated 50+ adults tend to take more medications.


9

Number of prescription medications

taken on a regular

basis

All 50+ Adults

Race/ Ethnicity Education Income

AA/B H/L HS or

Less

Some College

BA or more <$40K $40K-

$74,999 $75K-

$99,999 >$100K

1 17% 11% 15% 13% 19% 22% 12% 20% 18% 20%

2-3 39% 39% 40% 38% 41% 40% 35% 38% 45% 43%

4-5 23% 23% 21% 24% 22% 24% 26% 23% 22% 22%

6 or more 20% 28% 23% 26% 17% 14% 27% 18% 16% 14%

Subtotal: 4 or more 43% 51% 44% 50% 39% 38% 53% 41% 38% 36%


One-third of 50+ adults spend $50 or more per month on prescription medications and nearly three in ten (29%) say the costs are increasing.

1%

3%

8%

8%

13%

26%

16%

23%

0% 20% 40% 60% 80% 100%

More than $1000 per month

$500 but less than $1000





>$0 but less than $10

Nothing - $0

Amount spent per month on prescription drugs

33% spend $50 or

more per month

Q3: In the past 12 months, approximately how much have you spent out of your own pocket for prescription drugs? Q4: Thinking about what you currently pay in out-of-pocket prescription drug costs, would you say this amount is increasing, decreasing, or it has remained the same?

10

50+ adults say their out-of-pocket prescription drug costs are: Staying the same – 64% Increasing – 29% Decreasing – 5%


Changes in prescription drug coverage is the most common reason for an increase in out-of-pocket costs cited by over half (52%) of 50+ adults. About one in seven (14%) say their increase in out-of-pocket costs is due to an increase in the cost of the drugs.

1%

1%

3%

14%

20%

21%

22%

52%

0% 20% 40% 60% 80% 100%

Do not take prescription medication

Not covered by insurance

I no longer have prescription drugcoverage

Price increases/cost of drugs keeps goingup

I purchase different prescription drugs

I purchase more prescription drugs

I have different prescription drug coverage

There were changes in my currentprescription drug coverage

Q5: The list below includes possible reasons why your out of pocket costs for prescription drugs may be increasing. Please check all the reasons that apply to you.

11


About one-quarter (23%) of 50+ adults did not fill a prescription they were given within the last two years. More adults under 65, with some college or less, and a household income under $40,000 per year said they did not fill a prescription within the last two years.

Q6: In the last two years, did you ever decide not to fill a prescription that your doctor had given you?

12

23% of 50+ adults decided not to fill a prescription within the

last two years

Age Education Income

Percent who did not fill a prescription: • 27% (50-64) • 17% (65+)

Percent who did not fill a prescription: • 25% (HS or less) • 26% (Some college) • 17% (BA or more)

Percent who did not fill a prescription: • 31% (<$40K) • 20% ($40K-$74,999) • 17% ($75K-$99,999) • 18% (>$100K)

Four in ten who said their out-of-pocket prescription drug costs are increasing chose not to fill a prescription compared to 16% who said

their costs have stayed the same or decreased. Nearly four in ten (38%) with fair/poor health chose not to fill a prescription compared to

14% with excellent/very good health.


For 50+ adults who chose not to fill a prescription within the last two years, cost is the number one reason.

Q7: People may choose to not fill prescriptions for many reasons. Which of the following reasons apply to you? You many select all that apply Q8: Which is the MAIN reason that you didn’t fill your prescription?

13

Top Ten Reasons 50+ Adults Chose Not to Fill a Prescription in the Last Two Years Reason Prescription Was Not Filled Percent

Cost of the drug – 32% said this was the MAIN reason 55%

Did not think drug was necessary 28%

Side effects of drug 24%

I don’t like taking prescription drugs 19%

Drug concerned me 19%

Used/looked into other treatments 18%

Drug did not help 16%

Condition improved 14%

Thought drugs wouldn’t help much 13%

Already taking too many prescription drugs 13%

44% of 50+ adults with a Bachelor’s Degree or

more thought the drug wasn’t

necessary compared to only 22% of

those with HS or less.


Fewer than one in five 50+ adults have been faced with difficult decisions when buying prescription medications.

4%

7%

8%

12%

14%

15%

18%

0% 20% 40% 60% 80% 100%

Asked pharmacist for help paying forprescription

Cut back on food, fuel, or electricity toafford drug

Asked drug company for help paying forprescription

Skipped a dose to save money

Taken less medicine to make it last longer

Delayed filling prescription because didn'thave enough money

Decided not to fill a prescription because ofcost of drug

Percent who said “yes” they have been faced with the following decisions

Q9: Many people face difficult decisions when buying prescription drugs. In the past 12 months, have you or someone in your house hold…

14


Adults age 50-64 are struggling more with the cost of drugs than seniors.

3%

4%

6%

7%

10%

8%

11%

5%

10%

9%

15%

18%

20%

22%

0% 20% 40% 60% 80% 100%

Asked pharmacist for help payingfor prescription*

Cut back on food, fuel, or electricityto afford drug

Asked drug company for helppaying for prescription

Skipped a dose to save money

Taken less medicine to make it lastlonger

Delayed filling prescription becausedidn't have enough money

Decided not to fill a prescriptionbecause of cost of drug

Percent who have been faced with difficult decisions when buying prescription drugs

Age 50-64 Age 65+

Q9: Many people face difficult decisions when buying prescription drugs. In the past 12 months, have you or someone in your house hold… * Results are not statistically significant

15

Additional characteristics of 50+ adults who are likely to face difficult decisions when buying prescription drugs include adults who: • Earn less than $40K

per year • Have a high school

education or less • Regularly take

prescription medications

• Find that their out-of-pocket prescription costs are increasing

• Rate their health as either fair or poor


14%

30% 30% 25%

Very concerned Somewhatconcerned

Not veryconcerned

Not at allconcerned

0%

20%

40%

60%

80%

100% Concern about affording prescriptions over the next two years

Total Concerned: 44%

Total Not Concerned: 55%

About four in ten 50+ adults expressed concern about affording their prescription drugs in the next two years and over eight in ten (81%) think the costs of these drugs are too high.

Q10: How concerned are you about being able to afford the cost of needed prescription drugs over the next two years? Q11: Do you think the costs of prescription drugs are…?

16

Costs of prescription drugs are: Too high (81%) Right price (17%) Too low (<0.5%)


47% 41%

48% 49%

33%

53% 49%

41%

30%

Age 50-64 Age 65+ HS or less Some college BA or more <$40K $40-74.9K $75K-99.9K $100K+0%

20%

40%

60%

80%

100% Percent who are very or somewhat concerned about being able to afford their prescription medication over the next two years

Age Education Income

About half (48%) of 50+ adults with a high school education or less and over half (53%) of those with an income under $40,000 per year are concerned about paying for their medication compared to those with more education and income.

Q10: How concerned are you about being able to afford the cost of needed prescription drugs over the next two years?

17


59%

28%

8% 4%

Very important Somewhat important Not very important Not at all important0%

20%

40%

60%

80%

100%

Total Important: 87%

Total Not Important: 12%

Nearly nine in ten (87%) 50+ adults think it is important for politicians – especially those running for president -- to support efforts to control prescription drug costs.

Q12: How important is it to you that politicians -- especially those running for President – support efforts to make prescription drugs more affordable?

18

94% of AARP members say it’s important, 70% say VERY

important


59%

70% 75%

56% 63%

53%

64% 62%

53%

63%

50%

Gen Pop AA/B H/L Age 50-64

Age 65+ Male Female HS orless

BA ormore

<$40K $100K+0%

20%

40%

60%

80%

100%

Gender Education Income Race/Ethnicity

Age

More African-American/Black and Hispanic/Latino 50+ adults believe it’s very important for politicians to support making prescription drugs more affordable.

Q12: How important is it to you that politicians -- especially those running for President – support efforts to make prescription drugs more affordable?

19


Influence of Prescription Drug Companies

20


Most 50+ adults believe drug companies have at least some influence over politicians and health care professionals, in general, but believe they have less influence over their own health care professional.

59% 53% 36%

29% 38%

44%

6% 4%

12% 4% 2% 5%

0%

20%

40%

60%

80%

100%

Congress/statelegislatures

Health careprofessionals

Your health careprofessional

A lot of influence Some influence Only a little influence No influence at all

88% 91% 80%

Q13: How much influence do you think prescription drug companies have over members of Congress and state legislatures? Q14: How much influence do you think prescription drug companies have over what drugs health care professionals prescribe? Q15: How much influence do you think prescription drug companies have over what your health care professional prescribes?

21


Government Regulation of Prescription Drugs

22


Three-quarters (76%) of 50+ adults believe there should be more government regulation limiting the price of prescription drugs and half believe there should be more regulation to make sure these drugs are safe. Few see too much regulation on prescription drugs.

8%

7%

9%

50%

44%

76%

39%

47%

13%

0% 20% 40% 60% 80% 100%

Making sure prescription drugs aresafe

Making sure statements aboutbenefits and side effects made in

advertisements for prescription drugsare accurate and not misleading

Limiting the price of prescriptiondrugs

Too much regulation Not as much as there should be Right amount of regulation

84% of AARP members say there is not as much regulation

as there should be

Q16: We would like to get your opinion of current government regulation of prescription drugs. For each area below, do you think there is too much regulation, not as much regulation as there should be, or about the right amount of regulation?

23


African American/Black 50+ adults and adults with less education and income are more likely to believe that more regulation is needed.


24

Demographic Group

Percent who say there is not as much regulation as there should be

Ensuring prescription drugs are safe to use

Ensuring statements made about prescription drugs are accurate and not misleading

Limiting the price of prescription drugs

General population 50% 44% 76%

African-American/Black 66% 53% 73%

Hispanic/Latino 46% 44% 58%

Male 45% 42% 74%

Female 54% 46% 77%

HS or less 56% 49% 75%

Some college 52% 44% 77%

BA or more 39% 36% 76%

<$40K 54% 48% 72%

$40K-$74,999 55% 49% 80%

$75K-$99,999 53% 41% 77%

$100K or more 38% 35% 77%


50+ adults who rate their health less favorably say there is not as much regulation as there should be when it comes to ensuring prescription drugs are safe to use and that statements about prescription drugs are accurate. Adults with increasing out-of-pocket costs say more regulation is needed to limit the cost of the drugs.


25

Demographic Group

Percent who say there is not as much regulation as there should be

Ensuring prescription drugs are safe to use

Ensuring statements made about prescription drugs are accurate and not misleading

Limiting the price of prescription drugs

Out-of-pocket prescription drug costs

Increasing 51% 46% 81%

Decreasing/staying the same

50% 43% 74%

Health status

Excellent/very good 42% 39% 75%

Good 55% 47% 76%

Fair/poor 56% 49% 79%


Prescription Drug Advertisements

26


Most adults have seen a drug advertisement recently and a majority think that pharmaceutical companies spend too much money on advertising.

73% 61%

6%

8%

19% 28%

0%

20%

40%

60%

80%

100%

Advertising to patients Advertising to health professionals

Too much Too little About the right amount

Q17: Have you seen or heard any advertisements for prescription drugs in the past 30 days? Q18: Do you think pharmaceutical companies spend too much, too little, or about the right amount of money on advertising to patients? Q19: Do you think pharmaceutical companies spend too much, too little, or about the right amount of money on advertising to health professionals?

27

Majority (82%) of 50+ adults have

seen a drug advertisement in last 30 days. Nine in ten (89%) AARP

members have seen an ad in the

last 30 days.


50+ adults with a higher level of education and income are more likely to think that pharmaceutical companies spend too much on advertising. African-American/Black and Hispanic/Latino adults are less likely to say drug companies spend too much on advertising.

28

Demographic Group

Percent who have seen ads for prescription drugs

in last 30 days

Percent who think pharmaceutical companies

spend too much on advertising to patients

Percent who think pharmaceutical

companies spend too much on advertising to

health care professionals

General population 82% 73% 61%

African-American/Black 75% 44% 42%

Hispanic/Latino 68% 55% 48%

HS or less 75% 65% 55%

Some college 88% 75% 66%

BA or more 86% 83% 66%

<$40K 76% 64% 55%

$40K-$74,999 82% 72% 61%

$75K-$99,999 86% 77% 59%

$100K or more 88% 83% 70% Q17: Have you seen or heard any advertisements for prescription drugs in the past 30 days? Q18: Do you think pharmaceutical companies spend too much, too little, or about the right amount of money on advertising to patients? Q19: Do you think pharmaceutical companies spend too much, too little, or about the right amount of money on advertising to health professionals?


50+ adults who take prescription drugs on a regular basis and whose out-of-pocket drug costs are increasing, pay more attention to prescription drug advertisements.

29

Q17: Have you seen or heard any advertisements for prescription drugs in the past 30 days? Q18: Do you think pharmaceutical companies spend too much, too little, or about the right amount of money on advertising to patients? Q19: Do you think pharmaceutical companies spend too much, too little, or about the right amount of money on advertising to health professionals?

86%

71%

88% 80%

Yes No Increasing Staying the sameor decreasing

0%

20%

40%

60%

80%

100%Percent who have seen or heard drug advertisements in the

last 30 days

Out-of-pocket costs are:

Regularly taking prescription drugs?

50+ adults experiencing an increase in their

out-of-pocket prescription costs

say that pharmaceutical

companies spend too much on advertising to

patients (79% vs 71%) and health

care professionals (70% vs 58%)


A large majority of 50+ adults think drug companies make too much profit and should be required to explain their drug pricing.

83%

2%

14%

Too much profit Not enough profit About the right amount ofprofit

0%

20%

40%

60%

80%

100%

90% of AARP members think drug companies make too

much profit

Q20: In general, do you think pharmaceutical or drug companies make too much profit, not enough profit, or about the right amount of profit? Q21: Do you think drug manufacturers should be required to publicly explain how they price their products?

30

Over eight in ten (84%) 50+ adults, and over nine in ten (91%) AARP members, think

drug companies should publicly explain how they price

their products.


50+ adults who regularly take prescription drugs, have increasing out-of-pocket costs, have decided not to fill a prescription, and who rate their health less favorably are more likely to believe drug companies make too much profit and say they should explain their product pricing.

Q20: In general, do you think pharmaceutical or drug companies make too much profit, not enough profit, or about the right amount of profit? Q21: Do you think drug manufacturers should be required to publicly explain how they price their products?

31

Demographic group Percent of adults who think drug companies make too much profit

Percent of adults who think drug companies should publicly explain

their product pricing

Regularly takes prescription medications

Yes 84% 87%

No 79% 75%

Out-of-pocket drug costs

Increasing 88% 88%

Staying same/decreasing 81% 82%

Decided not to fill a prescription

Yes 91% 89%

No 81% 83%

Health rating

Fair/poor 90% 92%

Good 82% 85%

Excellent/very good 81% 80%


Virtually all 50+ adults say it is important for consumers and health professionals to be able to compare the safety and effectiveness of prescription drugs.

84%

14%

0% 1%

Very important Somewhat important Not very important Not at all important0%

20%

40%

60%

80%

100%

Q22: How important is it to you for consumers and health professionals to have access to information that compares the safety and effectiveness of prescription drugs?

32

Total Important: 98%


Overall, eight in ten 50+ adults say it should be legal to buy prescription drugs from Canada and Europe. Differences were seen by age, gender, and education level.

Q23: Currently U.S. law bans people from buying prescription drugs from Canada or Europe. Some people believe that the laws should be changed to all Americans to order prescription drugs from other countries as long as they are as safe and effective as those bought in the U.S.. Do you believe that it should be legal for people in the U.S. to order drugs from Canada and Europe or not?

33

Who says it should be legal to buy prescription medications overseas?

More seniors (83%) compared to those age 50-64 (78%).

More men (85%) than women (77%).

More 50+ adults (84%) with a Bachelor’s degree or more compared to adults with a high school education or less (77%).

More 50+ adults (86%) who are experiencing an increase in their out-of-pocket drug costs compared to adults whose costs are staying the same or decreasing (78%).


Two-thirds (66%) of 50+ adults strongly support allowing Medicare to negotiate for lower drug costs.

66%

27%

3% 2% 0%

20%

40%

60%

80%

100%

Strongly support Somewhat support Somewhat oppose Strongly oppose

Total Support: 93% 75% of AARP

members strongly support allowing

Medicare to negotiate lower drug prices

(total support=98%)

Q24: Currently Medicare is prohibited by law from negotiating prescription drug prices with pharmaceutical companies. Some policymakers have proposed allowing Medicare to use its bargaining power to negotiate lower prices for prescription drugs. Do you support or oppose allowing Medicare to use its bargaining power to negotiate lower prices for prescription drugs?

34


There is little support (13%) for drug companies to delay the availability of lower-cost generic substitutes.

3% 10%

27%

58%

0%

20%

40%

60%

80%

100%

Strongly support Somewhat support Somewhat oppose Strongly oppose

Total Oppose: 85%

Q25: Some drug companies with patents that are nearing expirations enter into agreements with other drug companies that delay generic versions of these drugs from becoming available. Do you support or oppose such agreements?

35


Demographics (continued)

D1. Are you registered to vote at your current address, or not? Yes 87%

No 11%

36

D2. Would you say that you always vote in presidential elections, usually vote, sometimes vote, rarely vote, or never vote? Always 74%

Usually 9%

Sometimes 4%

Rarely 3%

Never 9%

D3. Regardless of how you might have voted in the past, what do you usually consider yourself – a Democrat, a Republican, or some other party? A Republican 29%

A Democrat 38%

An Independent 24%

Other 6%

D4. Are you or your spouse, currently, a member of AARP? Yes 41%

No 59%


Most 50+ adults rate their health as good or better.

D5:Overall, how would you rate your health? Would you say it is…..

37

10%

31%

41%

14%

3% 0%

20%

40%

60%

80%

100%

Excellent Very Good Good Fair Poor

More than half (56%) of 50+ adults with annual household

incomes of $100K or more say their health is excellent or very good compared to one-quarter

(24%) of adults with a household income under $40K.


Type of health insurance

4%

4%

5%

5%

9%

9%

10%

10%

11%

24%

38%

0% 20% 40% 60% 80% 100%

Other government program

Spouse's former employer

None

Tricare/Tricare for life

Medi-gap supplemental…

Medicaid

Individually purchased plan

Spouse's current employer

Former employer

Current employer

Medicare

D6: Which of the following best describes your sources for health coverage? (Multiple responses allowed)

38


Demographics (concluded)

Gender

Male 47%

Female 53%

39

Race/Ethnicity

White, non-Hispanic 74%

Black, non-Hispanic 10%

Other, non-Hispanic 5%

Hispanic 10%

2+ Races, non-Hispanic 1%

Education

Less than high school 12%

High school 33%

Some college 26%

Bachelors degree or higher 29%

Income

Less than $40k 37%

$40K to less than $74,999 24%

$75K to less than $99,999 14%

$100K or more 26%

Age

50-64 57%

65 and over 42%

Documents

2015 Survey on Prescription Drugs · • While most 50+ adults think that pharmaceutical companies spend too much money on advertising to patients and health care professionals, less