The need for patient assistance programs

National polling and analysis find that even with Medicare reforms, many adults will still struggle to afford out-of-pocket prescription drug costs.

Despite Medicare reforms, charitable assistance programs are still needed

Recent Medicare reforms passed as part of the Inflation Reduction Act—including a $2,000 out-of-pocket cap for prescription drugs that will go into effect in 2025—are important steps toward addressing healthcare affordability.

However, while the PAN Foundation celebrates these historic reforms, recent polling and analysis reinforces that even with these reforms, many beneficiaries will still struggle with their out-of-pocket prescription drug costs. This is especially true for beneficiaries who are low-income, belong to a historically marginalized group, or experience a chronic or rare disease.

Charitable assistance from the PAN Foundation will continue to be a lifeline for many with high out-of-pocket medication costs.

Kevin L. Hagan, PAN Foundation President and CEO

Many continue to struggle to afford their medications

A national poll, released by PAN, showed that even with a $2,000 annual limit on prescription costs, many adults on Medicare would still struggle to afford their medications. Among all adults polled, about 75 percent said that it would be difficult to afford $2,000 in annual out-of-pocket prescription drugs. Concerns were especially high among Black and Hispanic adults, adults with incomes under $50,000, and adults with chronic or rare diseases.

Donut chart with person's face in center

75 percent of adults surveyed would find it difficult to afford $2,000 in out-of-pocket prescription costs.

Source: PAN Foundation national poll. October 2022

An analysis conducted by Avalere—sponsored by PAN—projects more than 2.6 million older adults on Medicare will have out-of-pocket spending high enough to reach the new $2,000 annual cap when it goes into effect in 2025. In addition, about 800,000 beneficiaries in 2024 and 200,000 beneficiaries in 2025 will spend more than 10 percent of their income on prescription medications each year.

Watch: Understanding the Need for Patient Assistance Post-Inflation Reduction Act, a live recording of PAN’s presentation and panel at Informa PAP 2023

Role of charitable assistance programs in addressing health equity

The PAN Foundation is working to advance equitable health outcomes by ensuring those most in need—including those who have been historically marginalized—can afford and access the care they need and deserve. We are committed to improving health equity by addressing disparities in healthcare and health outcomes due to long-standing, systemic racism and discrimination. Learn more about PAN’s advocacy efforts and position statements.

I think this [the reforms] is a start but there are a lot of us out there who are on a fixed income and $2,000 is not enough. Without a grant, I would not be able to afford my two expensive drugs in addition to the other medications I take.

Janice Turner, PAN grant recipient