Americans’ experience with the health care system continues to be defined by access and affordability challenges, and specifically, insurer- and pharmacy benefit manager (PBM)-imposed hurdles. As the fifth Patient Experience Survey (PES) from PhRMA/Ipsos reports, patients demand greater urgency in making meaningful strides toward affordable health care.
Here are three key takeaways from the survey, which have robust findings across patient populations, demographics, geographic areas and disease states:
1. Americans face abusive insurer and PBM practices that limit patient access to medicines.
Four in 10 (41%) insured Americans taking a prescription medicine report insurer- and PBM-imposed barriers to care in the past year, such as prior authorization or step therapy. The challenge is even more common for patients in need of reliable access to care, including insured Americans managing a chronic condition (51%). This number is even higher for patients with diabetes (54%), mental health conditions (59%) and respiratory conditions (62%).
2. Health care out-of-pocket costs are driving financial insecurity even for those with insurance.
Out-of-pocket costs are the top healthcare issue for insured Americans. A third of insured Americans (33%) say their out-of-pocket costs for health care services have increased over the past year; the number is higher for prescription out-of-pocket costs (38% among insured Rx patients). And of those who report difficulty affording their out-of-pocket costs, deductibles (43%) continue to be the main driver. It’s no surprise that 18% of insured Americans report having outstanding medical debt; a number has continued to rise steadily in our tracking since 2022 (13%).
3. Americans want to see increased accountability and transparency across health care and lower patient out-of-pocket costs.
Most insured Americans (90%) support cracking down on abusive insurer and PBM practices that can limit patients’ access to medicines. Many also want to address health care affordability by setting limits on health care out-of-pocket costs and requiring insurance plans to cover more products and services without a deductible (both 34%) — the top two desired changes to improve health care (out of 11 options). And nearly all insured Americans (94%) say it is important for policymakers to understand the barriers and challenges patients face when accessing care.
With only about one in four (28%) of insured Americans believing insurance currently provides everyone with affordable access to health care when it’s needed, most Americans have consensus that policymakers need to help improve the patient experience in health care.
Learn more by reading the full Patient Experience Survey here and find more patient-centered solutions at PhRMA.org/Middlemen.
PhRMA’s Patient Experience Survey is a research initiative to explore the challenges Americans face as they navigate the health care system. The poll was conducted among 2,592 American adults (age 18 or older), including 2,397 with insurance, from July 19 – August 1, 2024, using Ipsos’ probability-based KnowledgePanel®, and it is representative of the American adult population. The margin of sampling error is plus or minus 1.5 percentage points at the 95% confidence level, for results based on the entire sample of adults.
Cynthia Hicks
Cynthia Hicks is Senior Director of Public Affairs at PhRMA focusing on polling and opinion research that supports advocacy communications and strategy. Prior to joining PhRMA, Cynthia worked as a consultant, marketer, and head of polling for a civic technology company where her work supported issue advocacy organizations and policy makers on both sides of the aisle. Cynthia is a proud Los Angeles native and outside of the office she enjoys an early morning HIIT workout and spending time with friends and family.
Cynthia Hicks
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"Americans speak out on health insurance barriers and need for policy change, according to the latest Patient Experience Survey"
Burden on Patients
Health Insurance
PBMs/Insurance
Polling
Americans speak out on health insurance barriers and need for policy change, according to the latest Patient Experience Survey
"Americans speak out on health insurance barriers and need for policy change, according to the latest Patient Experience Survey"