Per-Prescription Drug Expenditure by Source of Payment and Income Level in the United States, 1997 to 2015

Wenxi Tang, Jing Xie, Fanxin Kong, Daniel C. Malone

Research output: Contribution to journalArticlepeer-review


Objectives: To evaluate expenditures and sources of payment for prescription drugs in the United States from 1997 to 2015. Methods: The Medical Expenditures Panel Survey (MEPS) was used for this analysis. Individuals with one or more prescription medicines were eligible for inclusion. Outcomes were the inflation-adjusted cost per prescription across all payment sources (self or family, public, private, and other sources) before and after the Medicare Part D benefit and the Affordable Care Act. Results: The cost per prescription increased from $38.56 in 1997 to $73.34 in 2015. Nevertheless, consumers’ out-of-pocket expenditures decreased from $18.19 to $9.61, whereas public program expenditures per prescription increased from $5.61 to $34.43 over this time. Out-of-pocket expenditures of individuals in the low-income group and near-poor group had larger declined percentages from 51.4% to 20.4% and 46.5% to 17.2% relative to individuals in higher-income groups before and after implementation of the Medicare Part D, respectively. Over 90% prescription purchases were covered by medical insurance by 2015. The per-prescription cost for medications consumed by uninsured individuals increased at a lower rate from $31.83 to $54.96 versus $40.12 to $75.58 for privately insured and $36.00 to $70.96 for publicly insured (P <.001). Conclusions: Prescription drugs expenditures have increased over the past 2 decades, but public sources now pay for a growing proportion of prescription drugs cost regardless of health insurance coverage or income level. Out-of-pocket expenditures have significantly decreased for persons with lower incomes since the implementation of Medicare Part D and the Affordable Care Act.

Original languageEnglish (US)
Pages (from-to)871-877
Number of pages7
JournalValue in Health
Issue number8
StatePublished - Aug 2019


  • cost
  • income level
  • medical insurance
  • payment
  • prescribed medicines

ASJC Scopus subject areas

  • Health Policy
  • Public Health, Environmental and Occupational Health


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