Center for Studying Health System Change

Working-Age Minorities Face Greater Prescription Drug Affordability Problems

Nearly 1 out of 3 African Americans with a Chronic Condition Went Without at Least One Prescription

News Releases
Dec. 30, 2003

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ASHINGTON, D.C.—Working-age African Americans and Latinos—particularly those with chronic conditions such as diabetes and heart disease—are much more likely than white Americans to report they cannot afford all of their prescription drugs, according to a national study released today by the Center for Studying Health System Change (HSC).

Overall, nearly one in five blacks (20%) and one in six Latinos (16%) 18 to 64 years old did not purchase at least one prescription drug in the previous year because of cost, compared with slightly more than one in 10 whites (11%), the study found.

"Surprisingly, the biggest disparities in access to affordable prescription drugs were among privately insured blacks, Latinos and whites—rather than among the uninsured," said Paul B. Ginsburg, Ph.D., president of HSC, a nonpartisan policy research organization funded exclusively by The Robert Wood Johnson Foundation.

"Rising copayments and coinsurance for prescription drugs may undercut efforts to reduce racial and ethnic disparities in access to health care because privately insured African Americans and Latinos—especially people with chronic conditions—already have more problems affording prescriptions," Ginsburg said.

According to the study, privately insured working-age African Americans and Latinos were about twice as likely as whites to report they did not fill all of their prescriptions in 2001. For example, about one in five privately insured African Americans and Latinos with at least one chronic condition reported they could not afford to fill a prescription in the previous year, compared with about one in 10 privately insured whites with at least one chronic condition.

The size of the prescription access gap was much greater, however, for those with chronic conditions than for those without such health problems. The gap between blacks and whites was 5 percentage points for those with no chronic conditions, 12 points for those with one condition and 15 points for people with multiple conditions. Similar, though generally smaller, gaps were found for Latinos as well.

"There are a variety of explanations for these disparities—most of them economic," said HSC Health Research Analyst Marie Reed, M.H.S., who co-authored the study with HSC Senior Researcher J. Lee Hargraves, Ph.D. "Blacks and Latinos generally earn less than whites and are less likely to work for employers offering health plans with generous prescription drug coverage."

The study’s findings are detailed in a new HSC Issue Brief—Prescription Drug Access Disparities Among Working-Age Americans—available online. Based on results from HSC’s Community Tracking Study 2001 Household Survey, a nationally representative survey involving about 60,000 people, including approximately 37,000 white, Latino and African Americans 18 to 64 years old.

Other key findings include:

• Uninsured whites, blacks and Latinos—particularly those living with chronic health problems—were all highly likely to report problems affording prescription drugs. For example, about 50 percent of the uninsured in each group with one or more chronic conditions didn’t purchase all of their prescriptions in 2001 because of cost.
• More than 35 percent of blacks and 30 percent of Latinos with multiple chronic conditions did not purchase all of their prescriptions in 2001 because of cost, compared with slightly more than 20 percent of whites.
• Working-age people with public insurance, including Medicaid and Medicare, were more likely than privately insured people to report problems affording prescription drugs. In particular, publicly insured African Americans living with chronic conditions were much more likely than whites or Latinos to have problems affording all of their prescriptions.

The Center for Studying Health System Change is a nonpartisan policy research organization committed to providing objective and timely insights on the nation’s changing health system to help inform policy makers and contribute to better health care policy. HSC, based in Washington, D.C., is funded exclusively by The Robert Wood Johnson Foundation and is affiliated with Mathematica Policy Research, Inc.