When asked for reason behind increasing health insurance premiums, payers frequently point to the rising cost of prescription drugs as one culprit, with insurers covering a larger share of prescription drug costs today than a decade ago.
An analysis from Peterson-Kaiser Health System Tracker examined drug spending for individuals with employer-based insurance, based on a sample of claims from the Truven MarketScan Commercial Claims and Encounters Database. Researchers calculated insurer and consumer drug spending between 2004 and 2014 among 785,000 to 15.3 million policyholders annually to map changes in drug spending.
Here are six statistics from the report.
1. The number of people with drug spending exceeding $5,000 annually increased from 1.6 percent in 2004 to 3.9 percent in 2014. In addition, the share of people with drug spending exceeding $20,000 annually increased from 0.1 percent to 0.8 percent in the same period.
2. Individuals receiving insurance through large employers on average spent $144 per person on drugs in 2014, down from $167 in 2009.
3. Individuals with large employer-based insurance saw on average annual out-of-pocket spending on prescriptions decrease by about $24 from 2009 to 2014. The drop is most likely attributed to brand name drugs losing patent protection.
4. Twenty-four percent of out-of-pocket prescription drug costs were paid through deductibles in 2014, up from only 4 percent in 2004.
5. Twenty percent of out-of-pocket drug spending was paid through coinsurance in 2014, up from only 3 percent in 2004.
6. Women saw a larger decrease than men in their share of out-of-pocket drug expenses. One reason why is that spending on oral contraceptive pills dropped from 20.9 percent in 2012 to 3.6 percent in 2016 in light of the ACA's contraception provision.