NCHS Data Brief ■ No. 333 ■ March 2019

U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES

Centers for Disease Control and Prevention

National Center for Health Statistics

Strategies Used by Adults Aged 18–64 to Reduce Their 

Prescription Drug Costs, 2017

Robin A. Cohen, Ph.D., Peter Boersma, M.P.H., and Anjel Vahratian, Ph.D., M.P.H.

Key findings

Data from the National 

Health Interview Survey

● Among adults aged 

18–64 who were prescribed 

medication in the past 12 

months, the percentage who 

used selected strategies to 

reduce their prescription drug 

costs in the past 12 months 

decreased from 2013 through 

2015 and then remained stable 

from 2015 through 2017.

● In 2017, among adults aged 

18–64 who were prescribed 

medication, women were more 

likely than men to use selected 

strategies to reduce their 

prescription drug costs.

● In 2017, strategies for 

reducing prescription drug 

costs were most commonly 

practiced among those who 

were uninsured compared with 

those with private insurance 

or Medicaid, as 39.5% asked 

their doctor for a lower-cost 

medication, 33.6% did not take 

their medication as prescribed, 

and 13.9% used alternative 

therapies. 

In 2017, nearly 60% of U.S. adults aged 18–64 reported being prescribed 

medication in the past 12 months (1). Approximately 70% of prescription 

medications carry out-of-pocket costs, with generics costing on average $6 and 

brand names costing on average $30 (2). Strategies to reduce prescription drug 

costs at the individual level may include asking one’s doctor for a lower-cost 

medication, not taking medication as prescribed, or using alternative therapies 

(3). This report examines changes over time in the percentage of adults aged 

18–64 who were prescribed medication and reported using these selected 

strategies to reduce their prescription drug costs in the past 12 months. 

Use of strategies to reduce prescription drug costs 

decreased from 2013 through 2015 and then remained 

relatively constant from 2015 through 2017 among adults 

aged 18–64 who were prescribed medication in the past 

12 months.

Figure 1. Percentage of adults aged 18–64 who were prescribed medication in the past 12 months 

who used selected strategies to reduce prescription drug costs, by year: United States, 2013–2017

1

Significant decreasing linear trend from 2013 through 2015 (p < 0.05) and remained constant from 2015 through 2017 (p < 0.05).

NOTES: “Did not take medication as prescribed” is a composite measure that includes adults who “skipped medication doses,” 

“took less medicine,” or “delayed filling a prescription.” See Definitions section for further details. A person may use more than one 

strategy to reduce prescription drug costs. Estimates are based on household interviews of a sample of the civilian 

noninstitutionalized population. Access data table for Figure 1 at: 

https://www.cdc.gov/nchs/data/databriefs/db333_tables-508.pdf#1.

SOURCE: NCHS, National Health Interview Survey, 2013–2017.

0

10

20

30

2013 2014 2015 2016 2017

Used alternative therapies1

Did not take medication as prescribed1

Asked doctor for lower-cost medication1

Percent

NCHS reports can be downloaded from: https://www.cdc.gov/nchs/products/index.htm.
NCHS Data Brief ■ No. 333 ■ March 2019

■  2  ■

● The percentage of adults aged 18–64 who were prescribed medication in the past 12 months 

who asked their doctor for a lower-cost medication decreased from 25.8% in 2013 to 19.8% 

in 2015, and then remained relatively constant from 2015 through 2017 (19.5%) (Figure 1).

● The percentage of adults aged 18–64 who did not take medication as prescribed decreased 

from 14.9% in 2013 to 11.1% in 2015, and then remained relatively constant from 2015 

through 2017 (11.4%).

● The percentage of adults aged 18–64 who used alternative therapies decreased from 

5.8% in 2013 to 4.8% in 2015, and then remained relatively constant from 2015 through 

2017 (5.4%).

The percentage who asked their doctor for a lower-cost medication was 

highest among women and uninsured adults.

● Among adults aged 18–64 who were prescribed medication in the past 12 months, 19.5% 

asked their doctor for a lower-cost medication in the past 12 months to reduce their 

prescription drug costs (Figure 2).

● Women (22.0%) were more likely than men (16.4%) to ask their doctor for a lower-cost 

medication.

Figure 2. Percentage of adults aged 18–64 who were prescribed medication in the past 12 months who asked their doctor 

for a lower-cost medication, by sex and health insurance status: United States, 2017

1

Significantly different from men (p < 0.05). 2

Significantly different from those with private and Medicaid coverage (p < 0.05).

NOTES: Estimates are based on household interviews of a sample of the civilian noninstitutionalized population. Access data table for Figure 2 at: 

https://www.cdc.gov/nchs/data/databriefs/db333_tables-508.pdf#2. 

SOURCE: NCHS, National Health Interview Survey, 2017.

2

39.5

0 10 20 30 40 50

15.7

18.0

Uninsured

Medicaid

Private

1

22.0

16.4

Women

Men

Total 19.5

Percent
NCHS Data Brief ■ No. 333 ■ March 2019

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● Uninsured adults (39.5%) were more than twice as likely as those with private health 

insurance (18.0%) or Medicaid coverage (15.7%) to ask their doctor for a lower-cost 

medication.

In 2017, the percentage who did not take their medication as prescribed 

to reduce their prescription drug costs was highest among women and 

uninsured adults.

● Among adults aged 18–64 who were prescribed medication in the past 12 months, 11.4% 

did not taken their medication as prescribed to reduce their prescription drug costs 

(Figure 3).

● Women (12.7%) were more likely than men (9.7%) to not take their medication as 

prescribed. 

● Uninsured adults (33.6%) were more likely than those with private health insurance (8.4%) 

or Medicaid coverage (12.5%) to not take their medication as prescribed, while adults with 

Medicaid coverage were more likely than those with private health insurance to use this 

strategy.

Figure 3. Percentage of adults aged 18–64 who were prescribed medication in the past 12 months who did not take their 

medication as prescribed to reduce prescription drug costs, by sex and health insurance status: United States, 2017

1

Significantly different from men (p < 0.05). 2

Significantly different from those with private coverage (p < 0.05). 3

Significantly different from those with Medicaid coverage (p < 0.05).

NOTES: “Did not take medication as prescribed” is a composite measure that includes adults who “skipped medication doses,” “took less medicine,” or “delayed 

filling a prescription.” See Definitions section for further details. A person may use more than one strategy to reduce prescription drug costs. Estimates are based 

on household interviews of a sample of the civilian noninstitutionalized population. Access data table for Figure 3 at: 

https://www.cdc.gov/nchs/data/databriefs/db333_tables-508.pdf#3.

SOURCE: NCHS, National Health Interview Survey, 2017.

0 10 20 30 40

2,333.6

2

12.5

8.4

Uninsured

Medicaid

Private

1

12.7

9.7

Women

Men

Total 11.4

Percent
NCHS Data Brief ■ No. 333 ■ March 2019

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The percentage who used alternative therapies to reduce their prescription 

drug costs was highest among women and uninsured adults. 

● Among adults aged 18–64 who were prescribed medication in the past 12 months, 5.4% 

used alternative therapies to reduce their prescription drug costs (Figure 4).

● Women (6.6%) were more likely than men (3.9%) to use alternative therapies.

● Uninsured adults (13.9%) were more likely than those with private health insurance (4.4%) 

or Medicaid coverage (6.4%) to use alternative therapies. Adults with Medicaid coverage 

were more likely than those with private health insurance to use alternative therapies.

Figure 4. Percentage of adults aged 18–64 who were prescribed medication in the past 12 months who used alternative 

therapies to reduce prescription drug costs, by sex and health insurance status: United States, 2017

1

Significantly different from men (p < 0.05). 2

Significantly different from those with private coverage (p < 0.05). 3

Significantly different from those with Medicaid coverage (p < 0.05).

NOTES: Estimates are based on household interviews of a sample of the civilian noninstitutionalized population. Access data table for Figure 4 at: 

https://www.cdc.gov/nchs/data/databriefs/db333_tables-508.pdf#4. 

SOURCE: NCHS, National Health Interview Survey, 2017.

Percent

1

6.6

3.9

0 5 10 15 20

2,313.9

2

6.4

4.4

Uninsured

Medicaid

Private

Women

Men

Total 5.4
NCHS Data Brief ■ No. 333 ■ March 2019

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Summary

Among U.S. adults aged 18–64 who were prescribed medication in the past 12 months, the 

percentage who did not take their medication as prescribed, asked their doctor for a lower-cost 

medication, or used alternative therapies to reduce prescription drug costs decreased from 2013 

through 2015, and then remained relatively constant from 2015 through 2017. In 2017, strategies 

for reducing prescription drug costs were most commonly practiced among those who were 

uninsured, as 39.5% asked their doctor for a lower-cost medication, 33.6% did not take their 

medication as prescribed, and 13.9% used alternative therapies. Women were more likely than 

men to use each of these strategies. 

In 2017, total retail prescription drug spending accounted for 10% of total national health 

expenditures. However, the growth in national retail prescription drug spending has slowed in 

recent years (4). Approximately 70% of prescriptions have an out-of-pocket cost, with the outof-pocket cost for a generic prescription costing on average $6 and a brand name prescription 

costing on average $30 (2). Cost-saving strategies to reduce prescription drug costs may have 

implications for health status and have been associated with increased emergency room use and 

hospitalizations compared with adults who follow recommended pharmacotherapy (5,6). 

Definitions

Strategies for reducing prescription drug costs: Based on the following questions: The following 

questions concern the use of prescription medication: During the past 12 months, are any of the 

following true for you? ...[1] You skipped medication doses to save money ...[2] You took less 

medicine to save money ...[3] You delayed filling a prescription to save money ...

[4] You asked your doctor for a lower-cost medication to save money ...[5] You used alternative 

therapies to save money. Adults were asked questions 1 through 4 only if they reported having 

been prescribed medication by a doctor or other health care provider during the past 12 

months. All adults were asked question 5, including those who might not be taking prescription 

medication. For this analysis, only those adults who were prescribed medication in the past 12 

months were included. 

Did not take medication as prescribed: Based on a positive response to any of the following three 

questions described previously: ...You skipped medication doses to save money ...You took less 

medicine to save money ... You delayed filling a prescription to save money.

Health insurance coverage: At the time of interview, respondents reported their type(s) of 

coverage. A health insurance hierarchy of four mutually exclusive categories was developed (7). 

Adults with more than one type of health insurance were assigned to the first appropriate category 

in the following hierarchy: Private coverage, Medicaid (includes state-sponsored health plans 

including the Children’s Health Insurance Program [CHIP]), other coverage (includes Medicare, 

other government, and military coverage), and uninsured. Adults with “other coverage” are 

included in the totals but are not shown separately.

In this report, strategies used to reduce prescription drug costs are based on the 12 months prior to 

interview, while health insurance coverage was measured at the time of interview. Therefore, the 

adults’ health insurance status may have been different at the time they used a strategy to reduce 

their prescription drug costs.
NCHS Data Brief ■ No. 333 ■ March 2019

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Data source and methods

Data from the 2013–2017 National Health Interview Survey (NHIS) were used for this analysis. 

NHIS is a nationally representative, household survey of the civilian noninstitutionalized U.S. 

population. It is conducted continuously throughout the year by the National Center for Health 

Statistics (NCHS). Interviews are conducted in the respondent’s home, but follow-ups to 

complete interviews may be conducted by telephone when necessary. For more information about 

NHIS, visit the NHIS website: https://www.cdc.gov/nchs/nhis.htm. 

Point estimates and the corresponding variances were calculated using SUDAAN software (8) 

to account for the complex sample design of NHIS. All estimates in this report meet NCHS 

standards of reliability as specified in “National Center for Health Statistics Data Presentation 

Standards for Proportions” (9). Linear trends by year were evaluated using logistic regression. 

Differences between percentages were evaluated using two-sided significance tests at the 

0.05 level. 

About the authors

Robin A. Cohen, Peter Boersma, and Anjel Vahratian are with the National Center for Health 

Statistics, Division of Health Interview Statistics.
NCHS Data Brief ■ No. 333 ■ March 2019

■  7  ■

References

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were prescribed medication in the past 12 months, by sex and age group—National Health 

Interview Survey, 2017. MMWR 68(4):97. 2019.

2. IQVIA Institute for Human Data Science. Medicine use and spending in the U.S.: A review 

of 2017 and outlook to 2022. 2018. Available from: https://www.iqvia.com/institute/reports/

medicine-use-and-spending-in-the-us-review-of-2017-outlook-to-2022. 

3. Cohen RA, Villarroel MA. Strategies used by adults to reduce their prescription drug costs: 

United States, 2013. NCHS Data Brief, no 184. Hyattsville, MD: National Center for Health 

Statistics. 2015.

4. Martin AB, Hartman M, Washington B, Catlin A. National health care spending in 2017: 

Growth slows to post-great recession rates; Share of GDP stabilizes. Health Aff (Millwood) 

38(1):96–106. 2019.

5. Heisler M, Choi H, Rosen AB, Vijan S, Kabeto M, Langa KM, Piette JD. Hospitalizations 

and deaths among adults with cardiovascular disease who underuse medications because of cost: 

A longitudinal analysis. Med Care 48(2):87–94. 2010.

6. Jha AK, Aubert RE, Yao J, Teagarden JR, Epstein RS. Greater adherence to diabetes drugs 

is linked to less hospital use and could save nearly $5 billion annually. Health Aff (Millwood) 

31(8):1836–46. 2012.

7. Bloom B, Simpson G, Cohen RA, Parsons PE. Access to health care. Part 2: Working-age 

adults. National Center for Health Statistics. Vital Health Stat 10(197). 1997. Available from: 

https://www.cdc.gov/nchs/data/series/sr_10/sr10_197.pdf.

8. RTI International. SUDAAN (Release 11.0.01) [computer software]. 2013.

9. Parker JD, Talih M, Malec DJ, Beresovsky V, Carroll M, Gonzalez Jr JF. National Center 

for Health Statistics Data Presentation Standards for Proportions. National Center for Health 

Statistics. Vital Health Stat 2(175). 2017. Available from: 

https://www.cdc.gov/nchs/data/series/sr_02/sr02_175.pdf.
NCHS Data Brief ■ No. 333 ■ March 2019

Keywords: medication • non-adherence • National Health Interview Survey Suggested citation

Cohen RA, Boersma P, Vahratian A. 

Strategies used by adults aged 18–64 to 

reduce their prescription drug costs, 2017. 

NCHS Data Brief, no 333. Hyattsville, MD: 

National Center for Health Statistics. 2019.

Copyright information

All material appearing in this report is in 

the public domain and may be reproduced 

or copied without permission; citation as to 

source, however, is appreciated.

National Center for Health 

Statistics

Jennifer H. Madans, Ph.D., Acting Director

Amy M. Branum, Ph.D., Acting Associate 

Director for Science

Division of Health Interview Statistics

Stephen J. Blumberg, Ph.D., Director

Anjel Vahratian, Ph.D., M.P.H., Acting

Associate Director for Science

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