Wolters Kluwer Pharma Solutions
Pharma Insight 2009
Sample represents more than 80% of the dispensing activity within the United States for retail prescriptions, inclusive of largest retail chains.
While payers still greatly influence patient access to treatment, increasingly, patients are weighing treatment cost and benefit, especially of new prescriptions.
2009: Commercial Rx Claims - New Rx
85.59% - Dispensed to patient
8.08% - Denied by health plans
6.33% - Abandoned by patients
Brand Rx - 9.30% abandoned
Generic Rx - 5.50% abandoned
Comment: This study covered 80 percent of the retail dispensing activity within the United States. It included patients for whom our health care system is working, at least theoretically. These individuals gained access to a physician, received one or more prescriptions, and then attempted to have the prescription filled by a retail pharmacy.
Private health plans that should be assisting patients in receiving the care that they should have, denied over 8 percent of the new prescriptions recommended by physicians.
Of all new prescriptions, over 6 percent were prepared but then abandoned by patients, primarily because of the high out-of-pocket costs of the prescription.
We need a health care system that ensures that all of us receive the health care that we need, including prescription drugs. A single payer national health program - an improved Medicare for all - would do just that. No one would walk away from a pharmacy empty handed.