Drug Prices Breaking Point
Most Americans are skipping doses — and demanding government price controls now.
In the past year, have you done any of the following because of the cost of a prescription medication?
Decided not to refill a prescription
I took prescription pills but didn't do any of these
Skipped doses
I wasn't taking prescription pills
Substituted a prescription
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Executive summary
America's prescription drug affordability crisis is no longer an abstract policy debate — it is reshaping how millions of people take their medicine. A new survey of 202 Americans finds that nearly eight in ten respondents (77.6%) are concerned about affording necessary prescription drugs, and 44.3% describe themselves as "very concerned" — a level of distress roughly double the 22% "very worried" share recorded in KFF's nationally representative polling.
The consequences are clinical, not just financial. Among respondents who take prescription medications, roughly 60% report at least one cost-driven behavior in the past year: skipping doses, declining to refill a prescription, or substituting a cheaper alternative. That non-adherence rate substantially exceeds the national benchmark of 31% of U.S. adults who report similar behaviors.
Respondents are not waiting for the market to fix this. Across multiple open-ended questions, the survey finds strong, consistent support for comprehensive government price controls — including negotiation, caps, and audits — with a clear preference for setting prices based on production cost plus a modest profit margin rather than value-based or R&D-recovery models.
The findings land at a pivotal moment: Medicare drug price negotiations under the Inflation Reduction Act took effect in January 2026, and a May 2025 executive order revived Most-Favored-Nation pricing proposals. Public pressure, this survey suggests, is running well ahead of policy.
Takeaway: Concern About Affording Prescription Drugs
Takeaway: Concern About Affording Prescription Drugs
Context
The Drug Price Survey collected 202 responses across five questions — one multiple-choice concern rating, one multi-select behavioral inventory, and three open-ended policy opinion questions. The survey was fielded online and drew respondents who, by their participation, likely have a heightened personal or civic stake in prescription drug pricing. That self-selection matters: it means the sample skews toward individuals with direct experience of drug cost hardship, which explains why concern and non-adherence rates run well above national averages.
The timing of this survey is significant. The policy landscape around drug pricing shifted meaningfully in 2024 and 2025. The Inflation Reduction Act's Medicare price negotiation provisions produced their first round of negotiated prices — covering 10 drugs — with those prices taking effect in January 2026 and projected to save the federal government $6 billion while cutting $1.5 billion in out-of-pocket costs for Medicare enrollees. In May 2025, President Trump signed an executive order reviving Most-Favored-Nation pricing, directing that U.S. drug prices align with the lowest prices paid by comparable nations. The Supreme Court, in a May 2026 ruling, declined to hear pharmaceutical industry challenges to Medicare negotiations, cementing the program's legal standing.
These developments form the backdrop against which respondents' opinions should be read. The survey captures public sentiment at a moment when government intervention in drug pricing has moved from campaign promise to enacted policy — yet the scale of that intervention remains limited relative to the breadth of the affordability problem. U.S. drug prices average 278% of prices in comparable countries, and brand-name originator drugs reach 422% of international prices before rebates, according to RAND Corporation analysis of 2022 data.
For the 50% of Medicare beneficiaries who report worrying about affording prescription drugs in 2026, and for the broader working-age population navigating high deductibles and formulary restrictions, the question is no longer whether prices are too high — it is how fast and how far policy will move to address them.
Takeaway: Cost-Driven Medication Behaviors in the Past Year
Takeaway: Cost-Driven Medication Behaviors in the Past Year
Level of Government Control
Extensive government intervention versus minimal government involvement
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Most respondents demand strong government intervention on drug prices, from cost-based caps to audits, with very few favoring a hands-off market approach.
Highlighted answers
- Comprehensive government price control (negotiation, caps, audits)
“Cost for consumers should be the total cost of production of the prescription, plus a VERY modest profit. No charging $80 for a pill that costs $0.25 to make.”
Directly echoes the survey's dominant theme of cost-plus pricing as the preferred framework for government-set drug prices.
- Comprehensive government price control (negotiation, caps, audits)
“I THINK A GOVERNMENT AUDIT BODY SHOULD REGULATE PRICES ACROSS THE MARKET AND SANCTION IMPOSED ON PARTIES WITH INFLATED PRICES”
Captures the survey's finding that respondents want not just caps but active enforcement mechanisms like audits and sanctions.
- Comprehensive government price control (negotiation, caps, audits)
“I think prescription drug prices should be regulated through expanding Medicare negotiation, and importation, price capping and international price reference, value based pricing,and wise regulation. Also, promoting competition and transparency is important as is limiting manufacturer abuse of exclu”
Reflects the breadth of policy tools respondents envision, aligning closely with the IRA negotiations and Most-Favored-Nation proposals described in the narrative.
- Limited government role; let the market set prices
“Not at all.”
Represents the rare but clear pro-market minority voice, illustrating that the low-government-control pole exists but is a decided outlier in this sample.
Regulation Scope
Universal price regulation versus regulation limited to essential medicines
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Respondents split between demanding universal price controls for all drugs versus limiting regulation to essential or life-saving medicines only.
Highlighted answers
- Regulate prices for all prescription drugs
“Cost for consumers should be the total cost of production of the prescription, plus a VERY modest profit. No charging $80 for a pill that costs $0.25 to make.”
Directly mirrors the survey's dominant theme of cost-plus pricing for all drugs, rejecting profit-maximizing models wholesale.
- Regulate prices for all prescription drugs
“I think the government should regulate prices based on cost of production; limit profits to be earned so that they can remain at least somewhat affordable”
Articulates the survey's most common policy preference — government-set, production-cost-anchored pricing across the entire drug market.
- Regulate prices for all prescription drugs
“I believe prescription drug prices should be regulated to make sure medications remain affordable and accessible for people who need them. No one should have to choose between paying for rent, food, or a prescription that could improve or even save their life. Of course, drug companies should prof”
Captures the real-world trade-off — rent versus medicine — that underpins the survey's high non-adherence and concern rates.
- Regulate prices only for essential or life‑saving drugs
“I think insulin should not be so expensive because type 1 diabetics will die without it.”
Represents the high-pole view that regulation should focus narrowly on life-sustaining drugs like insulin rather than the entire market.
- Regulate prices only for essential or life‑saving drugs
“If it helps they should be free, like cancer medicines or life threatening illnesses should be free”
Anchors the high pole by explicitly limiting the strongest price relief — free drugs — to life-threatening conditions only.
Conclusion
The picture this survey draws is of a public that has already made up its mind. Affordability anxiety is pervasive, non-adherence is widespread, and support for government intervention is not a soft preference — it is a demand backed by lived experience.
The policy window is open but narrow. Medicare's first round of negotiated drug prices took effect in January 2026 covering just 10 drugs. The Most-Favored-Nation executive order remains in early implementation. These are meaningful steps, but they are orders of magnitude smaller than the structural reform this survey's respondents are describing when they call for production-cost-plus pricing across all prescription drugs.
Three things to watch in the months ahead: First, whether the Medicare negotiation program expands to its full statutory scope — potentially covering hundreds of drugs by the late 2020s. Second, whether MFN pricing survives legal and diplomatic challenges and translates into measurable price reductions for non-Medicare patients. Third, whether the IRA's 2024 out-of-pocket cap for Medicare Part D enrollees reduces the cost-driven non-adherence rates documented here.
For anyone tracking drug pricing policy or public health outcomes, the signal from this survey is unambiguous: the public is not waiting for the pharmaceutical industry to self-correct. They want a system overhaul — and they want it now.
Takeaway: How concerned are you about your ability to afford necessary prescription drugs for yourself or your family?
Very concerned
Somewhat concerned
Not very concerned
Not at all concerned
Takeaway: How concerned are you about your ability to afford necessary prescription drugs for yourself or your family?
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