New findings from national health research organization Kaiser Family Foundation (KFF) shows
The findings come as U.S. healthcare spending is expected to surpass $6 trillion this year—up 6% from last year—driven in part by surging demand for specialty drugs, particularly expensive GLP-1 medications.
The consequences are significant:
- 20% of adults with multiple or complex conditions report not taking medications as prescribed because they cannot afford them.
- 33% say they struggled to pay or could not pay medical bills in the past year.
- 25% of adults with three or more conditions have cut household expenses to cover medical costs.
- 50% of adults with three or more conditions skipped or delayed care in the past year.
Another recent survey found that 96% of physicians have had patients stop taking medications because of cost without informing them.
The affordability challenge is also extending to employers.
Employer-sponsored plans cover most Americans, while employers now absorb more than 80% of health plan costs.
Employer healthcare costs are projected to rise another 9.5% in 2027, and the average employee is already expected to spend nearly $5,300 on healthcare in 2026.
Healthcare experts increasingly point to policy changes and greater transparency from pharmacy benefit managers (PBMs)—the middlemen between drug manufacturers, insurers and employers—as part of the solution.
“Greater visibility into prescription pricing and PBM practices can help employers identify lower-cost options, improve medication access for patients, and better protect employees from rising healthcare costs,” said Paul Pruitt, Co-founder of SHARx.
