Patients facing more health insurance barriers to accessing medications and treatment

One in three patients with a chronic condition say they’re facing more challenges accessing care and medications through their health insurance plan.

A recent national poll from the PAN Foundation’s Center for Patient Research finds that since the beginning of 2025, more than one in three (35 percent) of adults with a chronic condition have faced barriers accessing their medication or treatment through their health insurance plan.

In addition, one in three adults with a chronic condition report encountering insurance-related barriers more often in 2025 when compared to 2024, including increased cost-sharing (40 percent), formulary changes (37 percent), prior authorization (35 percent), and step therapy (32 percent).

Among those who have experienced an insurance-related barrier this year, 66 percent report at least a mild impact on their ability to access their prescribed medications or treatments, with 35 percent reporting a severe or moderate impact. For 16 percent of adults with a chronic condition, these barriers have diminished their confidence in their ability to access their medications or treatments for the rest of 2025.

“This recent polling reinforces the impact utilization management practices, such as step therapy, prior authorization, and formulary and plan changes, can have on patients,” said Amy Niles, Chief Mission Officer at the PAN Foundation. “These practices can disrupt care and negatively impact clinical outcomes for patients.

Insurers and health plans use certain utilization management strategies—including step therapy, prior authorizations, mid-year plan changes, and placement of drugs on specialty medication tiers—to control costs. These practices can create significant barriers to care for patients by delaying necessary treatment prescribed by their doctors. Read our position on curbing utilization management practices.

Niles adds, “That’s why we at the PAN Foundation will continue to ask Congress, as well as public and private insurers, to take steps to reduce and streamline these practices. In addition to our advocacy work around these topics, we also continue to provide patients and healthcare professionals with educational resources about these practices and to share real patient stories about how they’ve impacted the health and wellbeing of people across the country. Because everyone deserves access to the care they need.”

Related patient stories

• Jeff’s story: fighting for the care he needs
• Karen’s story: MS and step therapy
• Share your experience with healthcare policies

Polling methodology

This survey was conducted online within the United States between May 27-29, 2025, among 2,095 adults (aged 18 and over) by The Harris Poll on behalf of the PAN Foundation via its Harris On Demand omnibus product.

Data were weighted where necessary by age, gender, race/ethnicity, region, education, marital status, household size, household income, [employment], and political party affiliation, to bring them in line with their actual proportions in the population.

Respondents for this survey were selected from among those who have agreed to participate in our surveys. The sampling precision of Harris online polls is measured by using a Bayesian credible interval. For this study, the sample data is accurate to within + 2.5 percentage points using a 95% confidence level. This credible interval will be wider among subsets of the surveyed population of interest.

All sample surveys and polls, whether or not they use probability sampling, are subject to other multiple sources of error which are most often not possible to quantify or estimate, including, but not limited to coverage error, error associated with nonresponse, error associated with question wording and response options, and post-survey weighting and adjustments.

About the PAN Foundation

As a leading charitable foundation and healthcare advocacy organization, the PAN Foundation is dedicated to accelerating access to treatment for those who need it most and empowering patients on their healthcare journeys. We provide critical financial assistance for treatment costs, advocate for policy solutions that expand access to care, and deliver education on complex topics—all driven by our belief that everyone deserves access to affordable, equitable healthcare.

Since 2004, our financial assistance programs have helped more than 1.3 million people to start or stay on life-changing treatment. In addition, we’ve achieved major policy victories that increase access to care, mobilized patient advocates to call for change, and educated people nationwide on critical healthcare-related topics. We’re committed to working towards a future where equitable health outcomes are a reality for all.