Tracking Prescription Out Of Pocket Spending: GoodRx Research Methodology

GoodRx Research is tracking what it's like to be a patient at the pharmacy, including costs, coverage issues, and other problems people run into when filling prescriptions. Our prescription out-of-pocket spending tracker can be found here.

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To estimate the burdens consumers face trying to access their prescription medications, we tapped into multiple data sources, including national claims data and large, representative surveys. We detail these sources below. These numbers are our best estimate of the costs patients encounter at the pharmacy, given the most current data available.

However, these estimates will not necessarily determine future estimates, which will incorporate new and relevant data as appropriate.

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Retail prescription medication costs

To estimate the number of prescriptions filled and out-of-pocket spending to date in 2024, we tracked paid claims in a third-party national sample of all-payer prescription claims. We focused on retail prescription medications. We excluded medications that a healthcare professional must administer and medications administered in a hospital inpatient or long-term care setting.

To get a national estimate of retail prescription medication costs, we used estimates from IQVIA and Drug Channels Institute to adjust third-party sample claims by applying a multiplier based on data from 2022 to 2023. We made additional corrections to account for pure cash-pay claim counts to ensure alignment across data sources. We also adjusted for missing claims due to outages at Change Healthcare caused by a cyber ransom attack.

Using these corrected third-party sample claims and the multiplier, we projected national totals for 2024 on both a monthly and year-to-date (YTD) basis.

To get a national estimate of retail prescription out-of-pocket spending, we used data from the Medical Expenditure Panel Survey and National Health Expenditure accounts to adjust third-party sample claims by applying a multiplier based on data from 2019 to 2022. We made additional corrections to account for missing claims caused by outages at Change Healthcare due to a cyber ransom attack.

Using these adjusted third-party sample claims and the multiplier, we projected national totals for 2024, both on a monthly basis and YTD.

To track changes in prescription medication list prices, we used data on the published list prices set by the manufacturers of prescription drugs, and the prescription drug mix as dispensed by community retail pharmacies. We calculated our list price index daily, taking into account day-to-day changes in list prices and quarterly changes in the prescription drug mix. The index is based on the prescription medication mix as dispensed, so price changes in high-volume and high-cost drugs will have more impact on the index than low-volume and low-cost drugs.

Our list price index uses a nationally representative sample of prescriptions from each quarter to estimate the drug mix across all community retail pharmacies for that time period.

Insurance coverage trends

We reported insurance coverage trends based on GoodRx Research's analysis of Medicare Part D formulary data. More detail on the methodology is covered here.

Problems accessing prescription medications

We reported access to pharmacies based on GoodRx Research's analysis of healthcare deserts. More detail on the methodology is covered here.

To estimate problems consumers face at the pharmacy counter that weren't captured by claims data, we ran a 3-month survey of 3,000 Americans. Our survey was run through YouGov, in three waves. The survey ran from February 9 to February 23, 2024; March 1 to March 21, 2024; and April 1 to April 13, 2024.

In each wave, we collected 1,000 responses. We weighted survey responses to the U.S. population using age, gender, race, political affiliation, and education level. More information on the YouGov survey is available here.

To estimate the number of Americans who left a prescription at the pharmacy each month, we multiplied our survey's incidence rate by the percentage of respondents who reported leaving at least one prescription at the pharmacy. This number was then multiplied by the total number of American adults, based on data from the 2019 American Community Survey from the U.S. Census Bureau.

References

Agency for Healthcare Research and Quality. (2023). Medical Expenditure Panel Survey.

Centers for Medicare & Medicaid Services. (2023). National health expenditure data.

View All References (4)

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Fein, A. (2024). The 2024 Economic Report on U.S. Pharmacies and Pharmacy Benefit Managers. Drug Channels Institute.

IQVIA. (2024). The use of medicines in the U.S. 2024: Usage and spending trends and outlook to 2028.

U.S. Census Bureau. (2019). 2019 data release new and notable.

YouGov. (2023). About YouGov.

GoodRx Health has strict sourcing policies and relies on primary sources such as medical organizations, governmental agencies, academic institutions, and peer-reviewed scientific journals. Learn more about how we ensure our content is accurate, thorough, and unbiased by reading our editorial guidelines.

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