One in three U.S. adults cannot afford to take their medication as prescribed due to cost. For over a decade, the United States has had the highest per capita prescription drug spending in the world, reaching around $1,432 per American in 2021. Close to nine in 10 U.S. adults agree that the cost of prescription drugs is “usually much higher” or “tends to be somewhat higher” than what is fair for consumers to be paying. Despite these concerns, drug price increases continue to run rampant in the United States. To shed light on medication cost trends and struggles, the team at NY Requirements has collected data from the U.S. Department of Health and Human Services and AARP to create a comprehensive analysis of which drugs have increased the most in price both recently and historically:

Click here to download the printable PDF version of the chart.

Which country has the most expensive prescription drugs?

According to a recent analysis by RAND, a nonprofit and nonpartisan organization that explores public policy challenges, drug prices in the United States are, on average, 2.78 times more expensive than in other countries. That means that across all medications, U.S. drug prices were 278% more expensive on average! That number becomes even more staggering when generic medications are removed from the equation; brand-name originator drugs were 422% more than other countries analyzed! If you are interested in further reading on this topic, the Assistant Secretary for Planning and Evaluation (the principal advisor to the Secretary of the U.S. Department of Health and Human Services) has provided a detailed study on international drug pricing and how U.S. drug prices compare to other countries.

Two more eye-opening notes – The United States is one of the only two (the other being New Zealand) that allows direct-to-consumer prescription drug advertisements. The United States also churns out the most drug prescriptions in the world.

Why are drugs so expensive in the U.S.?

Drug prices in America are notoriously expensive, making it difficult for many Americans to afford the medications they need. As we explored above, the United States is the country with the highest drug prices. So why is medication so expensive in the U.S.? There are several key factors at play:

Drug companies are motivated by profit. Despite claims that the high costs are necessary to recuperate costs of research and development, studies have shown there is no correlation between R&D costs and drug prices. Sixty drugs approved between 2009 and 2018 were analyzed.

Cost-sharing. In recent years, insurers have been shifting costs to patients through higher deductibles, co-pays, and premiums. The justification is that this would discourage people from seeking out unnecessary medical help, but the opposite is also true.

Patents and legal maneuvers.  Drug companies will often file patents or sue potential competitors to extend their monopoly on the medication. This also prevents the creation of more affordable generic versions. Drug patents in the U.S. last for 20 years, further aggravating the issue.

Advertising. As mentioned above, the U.S. is one of two nations that allows direct-to-consumer prescription drug advertisements. In fact, most major drug manufacturers spend more on marketing and selling their products than R&D.

Lobbying. In 2022, Big Pharma spent $372 million on lobbying in Congress and other federal agencies. That was over half of the total spend on lobbying in the healthcare sector.

For a thorough breakdown, check out the National Library of Medicine’s article aptly titled: "Why are our medicines so expensive? Spoiler: Not for the reasons you are being told..."

Are drug prices increasing faster than inflation?

Absolutely. Between January 2022 and January 2023, over 4,200 medications had price increases. Of those, 46% were greater than the rate of inflation. The average drug price increase over this period was 15.2%, equating to about $590 per medication. Fortunately, there is some hope on the horizon. In March 2024, The U.S. Department of Health and Human Services announced that 41 drugs that are available through Medicare Part B will have a lowered coinsurance rate if the drug company increases prices faster than the inflation rate. Around 763,700 people with Medicare take at least one of these drugs annually, and the program could save them between $1 and $3,575 on average per dose.

How many people die each year because they cannot afford medication?

The sobering reality behind U.S. medication price increases (and just healthcare costs in general) is that people die due to being unable to afford the prescriptions they need. Seniors are the most significantly affected by high drug prices and drug price inflation. A 2020 study conducted by the Council for Informed Drug Spending Analysis uncovered these shocking conclusions:

By 2030, on average:

• 1.1 million seniors could die prematurely because they are unable to afford their medications
• Medicare is projected to spend an additional $177.4 billion on healthcare costs that could have been avoided if medication was more accessible
• 70,400 premature deaths from chronic kidney disease, 69,300 premature deaths from chronic obstructive pulmonary disease, and 62,700 premature deaths from diabetes may occur because medication is financially unattainable

Are you struggling to afford your medications? Here are a few resources that may help:

5 ways to get help with prescription costs – Medicare.gov

How to Get Low-Cost or Free Prescriptions – WebMD

Drug Assistance Program – Asthma and Allergy Foundation of America

How to Make Prescription Drugs More Affordable — With or Without Insurance – GoodRX

Help Paying for Prescription Medicines – American Cancer Society

Top 10 Drugs That Increased the Most in Price in One Year (2022-2023)

Price Increases of the Top 25 Medicare Drugs Since Each Drug Came on the Market

Based on Prescription Medications That Medicare Spends the Most On

Related: Nurse practitioner prescribing controlled substances course for NYS, and other NYSED required courses

Sources:

AARP aarp.org/politics-society/advocacy/info-2023/medicare-drug-prices-triple.html

Office of Health Policy spe.hhs.gov/sites/default/files/documents/0cdd88059165eef3bed1fc587a0fd68a/aspe-drug-price-tracking-brief.pdf