Feb 19, 2026
Prescription drugs are expensive, and in many cases out of reach for Americans.
According to a 2025 survey published by GoodRx, a platform that tracks prescription drug prices, 27% of Americans had left a prescription unfilled because of the high cost (1).
Advertisement
“This finding is alarming given that nonadherence, or not taking a medication as prescribed, can worsen chronic conditions,” GoodRx stated in its findings. High costs can force people “to make difficult choices between prioritizing their health and managing other essential expenses,” leading to increased costs in the long run.
It’s a problem that affects both the insured and uninsured.
Why insurance doesn't always help
One out of five Americans (20%) has at least one drug their insurance doesn’t cover, according to the GoodRx survey. Often when insurance doesn’t cover a drug, patients are on the hook for the full price, which can lead to financial strain and gaps in treatment. As for the price paid, on average, 23% of Americans who aren’t covered by Medicaid spend more than $50 per month out of pocket on their prescriptions.
The type of insurance plan you have is one determinant of how much you’ll pay for drugs. Those with a health exchange plan or private plan pay more than those on Medicare, Medicaid or Tricare, per the survey.
It also matters if your insurance is a copay plan or coinsurance plan. A copay stipulates that you pay a flat dollar amount when you pay for your prescription, while coinsurance means you pay a percentage of the cost. If the drug is expensive, coinsurance means you could end up paying a large chunk of it out of pocket.
And if you have no coverage, your options are even more limited. And that’s not an insignificant number of people: about 8% of Americans are uninsured, according to KFF (2).
Must Read
- Dave Ramsey warns nearly 50% of Americans are making 1 big Social Security mistake — here’s what it is and the simple steps to fix it ASAP
- Robert Kiyosaki begs investors not to miss this ‘explosion’ — says this 1 asset will surge 400% in a year
- Vanguard reveals what could be coming for U.S. stocks, and it’s raising alarm bells for retirees. Here’s why and how to protect yourself
Join 250,000+ readers and get Moneywise’s best stories and exclusive interviews first — clear insights curated and delivered weekly. Subscribe now.
Other reasons you might pay more
One other factor that could increase how much you pay for medication is something called formulary tiers. The formulary is a list of drugs covered by your insurance plan. The medications on this list can be categorized into tiers that determine how much you pay out of pocket. For example, lower-tier drugs generally have the lowest copays.
If you need a drug that’s not listed in the formulary, you’ll need to either get prior authorization from your insurance provider to have it covered or pay the entire cost yourself.
The practices of pharmacy benefit managers (PBMs) may also be driving some drug prices higher. PBMs essentially serve as the middleman in the drug insurance ecosystem. They work with insurance companies to help set and manage the formularies, negotiate drug prices with manufacturers, organize pharmacy networks and help with plan administration.
Advertisement
Some of these practices can lead to higher drug costs. Congress passed reforms on Feb. 3 to make PBMs more transparent in the hopes that this will help lower drug prices, although the effects may not be felt for years.
Some consumers may benefit from lower drug prices if they use preferred pharmacy networks. These are groups of pharmacies chosen by an insurer that charge the insurer’s policyholders lower copays. You have the option to choose any pharmacy, but you might pay less at a preferred pharmacy.
Strategies to lower your drug costs
There are ways you could potentially save money on prescriptions. One is simply to shop around. For example, WFTV Channel 9 found that “just driving to a different store could save consumers hundreds of dollars” (3).
You could ask your doctor to prescribe generic drugs, use drug discount cards or coupons, seek out manufacturer discounts and check if online stores might sell your prescriptions for less. It also can’t hurt to ask your pharmacist about ways to save money, such as purchasing monthly prescriptions in advance or buying in bulk.
There may also be financial assistance available through government programs or nonprofit organizations. Many states also have a State Pharmaceutical Assistance Program, while some provide discount programs.
Things can change, so it’s worth reviewing your insurance coverage each year. Make sure your prescriptions are still covered in your provider’s formulary. If not, investigate whether another plan might suit you better. Also consider a combination of deductible, copay and coinsurance that will help you pay as little as possible.
Prescriptions can be expensive, even if you have health insurance. But with a bit of effort, you can reduce your cost burden — without skipping your meds.
Article sources
We rely only on vetted sources and credible third-party reporting. For details, see our editorial ethics and guidelines.
GoodRx (1); KFF (2); WFTV Channel 9 (3)
You May Also Like
- Turning 50 with $0 saved for retirement? Most people don’t realize they’re actually just entering their prime earning decade. Here are 6 ways to catch up fast
- This 20-year-old lotto winner refused $1M in cash and chose $1,000/week for life. Now she’s getting slammed for it. Which option would you pick?
- Warren Buffett used these 8 repeatable money rules to turn $9,800 into a $150B fortune. Start using them today to get rich (and stay rich)
- Here are 5 easy ways to own multiple properties like Bezos and Beyoncé. You can start with $10 (and no, you don’t have to manage a single thing)
Vawn Himmelsbach is a veteran journalist who has been covering tech, business, finance and travel for the past three decades. Her work has been featured in publications such as The Globe and Mail, Toronto Star, National Post, Metro News, Canadian Geographic, Zoomer, CAA Magazine, Travelweek, Explore Magazine, Flare and Consumer Reports, to name a few.
