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Access to health insurance coverage doesn’t always mean patients have access to the health care services and medicines they need. A new poll, commissioned by the Biotechnology Innovation Organization (BIO) and conducted by Morning Consult, reveals many Americans are caught in an insurance system that routinely slows or prevents access to life-saving medicines.
The poll of approximately 2,200 adults finds that access barriers can lead to consequences that compromise patient outcomes, and voters strongly support common-sense solutions that would make it easier for patients to access the medicines their doctors prescribe.
Here are three key takeaways from the new poll showing how the health care system impacts patients:
#1. Access barriers are all too common in health care. Thirty-five percent of adults surveyed said they had experienced some form of utilization management (UM) practice that insurance companies and drug middlemen (known as pharmacy benefit managers or PBMs) use to restrict access to medicines. The most common practices were prior authorization (54%) and lack of insurance coverage (44%). However, more than 15% of Americans had to try and fail on a medicine preferred by their insurance company before getting the medicine prescribed by their doctor (an insurance practice known as step therapy).
#2. Access barriers force patients to make difficult choices. Nearly half (47%) of people who experienced an access barrier said they had put off picking up or taking their medicine. Another 27% said they didn’t fill the prescription altogether and nearly one in five (18%) skipped one or more doses. If patients don’t adhere to the medicines prescribed by their doctors, they can experience adverse health outcomes and require more costly health care interventions (e.g., visit the emergency room or be admitted to the hospital).
#3. People want solutions that put the patient-doctor relationship first. More than half (57%) of respondents strongly agree that only doctors should decide whether a treatment is medically necessary for patients and 81% agree that state and federal lawmakers should help ensure patients have timely access to their medicines by limiting access barriers like prior authorization and step therapy. More specifically, 72% of respondents agree there should be exceptions for patients who are forced to “fail first” on different medicines, to prevent adverse reactions or delays in effective treatment.
When people are sick, they deserve timely access to the treatments and cures they need. But as this new poll shows, too often, timely access is denied by an insurance system that comes between patients and medicines. The American people are looking to lawmakers to help make sure the health insurance system delivers the health care people need.
