KFF research has consistently highlighted prescription drug costs as a critical health policy issue that captures public interest and concern. Our surveys reveal that the majority of individuals take at least one prescription medication and recognize their societal benefits; however, a significant portion believes these drugs are too costly, with three in ten struggling to afford their medications. The public has historically backed various strategies to reduce prescription drug prices, including allowing Medicare to negotiate prices, a key element of the Inflation Reduction Act (IRA) enacted in 2022. Nonetheless, over two years after the IRA’s passage, a large majority of the public remains unaware of the drug pricing measures included in the legislation.

Here are some key insights regarding the public’s experiences and perceptions regarding prescription medications and their costs.

Prescription drugs impact the lives of most Americans. Approximately six in ten adults report currently taking at least one prescription drug, while one-quarter state they are on four or more medications.

In addition to using prescription drugs, a majority of the public acknowledges the advantages these medications provide. About six in ten (63%) adults believe that prescription drugs developed over the last two decades have generally improved life for people in the U.S., whereas a much smaller portion (21%) feels they have worsened it.

Despite their perceived benefits, around eight in ten adults (82%) deem the cost of prescription drugs to be unreasonable. The public identifies profits made by pharmaceutical companies as the chief factor in these high prices. Over 80% of adults from all political affiliations consider pharmaceutical company profits to be a “major factor” in prescription drug pricing, followed by more than half who attribute costs to research and development expenses and nearly half who cite marketing and advertising costs as significant contributors.

More than half (55%) of adults express concern about their family’s ability to afford prescription drug costs, with a quarter (26%) being “very” worried. A greater percentage of Black (61%) and Hispanic (69%) adults report worries about affording the costs compared to White adults, half of whom share this concern. Additionally, 67% of uninsured adults under 65 report worries about affording prescription drugs, while over half (54%) of insured adults also express concerns about these costs.

While about two-thirds (65%) of adults overall find it very or somewhat easy to cover their prescription drug costs, affordability becomes a larger issue for those taking four or more medications. Nearly four in ten (37%) individuals on four or more prescriptions report challenges in affording their medications, compared to one in five (18%) adults taking three or fewer prescriptions. Adults earning less than $40,000 annually are also more likely to experience difficulties in affording their prescription medications compared to those with higher incomes.

Approximately three in ten adults reported not taking their medications as prescribed at some point in the past year due to financial constraints. This includes about one in five who either did not fill a prescription (21%) or opted for an over-the-counter alternative (21%), with 12% indicating they cut pills in half or skipped doses because of costs. The rates of not filling prescriptions, using over-the-counter drugs instead, or skipping doses increase to roughly four in ten among adults aged 18-29 (40%), Hispanic adults (39%), those taking four or more prescriptions (37%), and individuals in households earning less than $40,000 (37%).

The July 2023 KFF Tracking Poll shows that three in four adults believe there is “not enough regulation” to control the pricing of prescription drugs. While partisan views can differ regarding the extent of government regulation in other sectors, a majority across party lines—including 82% of Democrats, approximately 68% of Republicans, and around 67% of independents—agree that there is “not as much regulation as there should be” concerning prescription drug pricing.

For decades, lawmakers have debated drug pricing reform, with the Inflation Reduction Act, or IRA, being the first significant piece of recent legislation aimed at lowering prescription drug prices. Prior to the IRA’s passage in 2022, majorities from both parties supported various initiatives, including allowing the federal government to negotiate lower medication prices for Medicare recipients, which is a central aspect of the IRA. Traditionally, majorities have also backed measures such as increasing taxes on pharmaceutical companies that refuse to negotiate drug prices with the government, capping price increases based on annual inflation rates, permitting Americans to import drugs from Canada, setting annual limits on out-of-pocket drug expenses for Medicare beneficiaries, and facilitating the entry of generic drugs into the market.

As of September 2024, many voters remain unaware of the Medicare drug pricing measures in the IRA, which was passed by Congress and ratified by President Biden in 2022. Awareness of some provisions is notably higher among older voters, the demographic most affected by these changes. Four in ten voters know that a federal law exists limiting insulin costs for Medicare recipients to $35 per month, while approximately a third (35%) are aware of the law mandating federal negotiations for some prescription drugs for Medicare. About a quarter (27%) are informed about the law introducing an annual limit on out-of-pocket costs for Medicare recipients, and one in eight (12%) are aware of penalties for drug companies increasing prices faster than inflation for Medicare patients. Notably, a higher percentage of older voters (61%) recognize the $35 cap on insulin as part of existing law.

Overall, nearly nine in ten (85%) voters favor the federal government having the authority to negotiate drug prices for Medicare beneficiaries as outlined in the IRA, with only one in seven (14%) opposing it. This provision enjoys support from 92% of Democratic voters, 89% of independent voters, and 77% of Republican voters.

Majorities of voters, both overall and across party affiliations, support two proposals aimed at expanding the IRA’s provisions beyond Medicare’s scope. Approximately three-quarters (77%) favor a proposal that extends the $35 cap on out-of-pocket insulin costs to those without Medicare, including majorities from both parties—84% of Democrats, 79% of independents, and 70% of Republicans. Additionally, about seven in ten (69%) voters support a proposal to broaden the $2,000 annual cap on out-of-pocket prescription drug expenses to individuals not covered by Medicare, including 83% of Democrats, 70% of independents, and 58% of Republicans.