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| SURVEY SUMMARY | |
 September 2000 
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The following survey conducted by the NewsHour with Jim Lehrer, the
Henry J. Kaiser Family Foundation and the Harvard School of Public Health
provides extensive information about public perception of prescription
drug coverage. |
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A new national survey by The NewsHour with Jim Lehrer, the Kaiser Family Foundation, and the Harvard School of Public Health finds that the public is supportive of policy proposals to help extend prescription drug coverage to the elderly. The majority of Americans now say that the Medicare program currently does not cover prescription drugs and supports guaranteeing such coverage to everyone on Medicare even if it requires spending more to do so. To provide the elderly with this drug coverage, the majority prefers expanding Medicare directly as opposed to using private insurance plans, even after hearing arguments for and against these approaches. The survey also finds that a majority of the public is concerned about the costs of prescription medicines and around half favors allowing pharmacies and wholesalers to import lower-priced prescription drugs from other countries. Prescription drugs are a mainstay in most Americans’ lives, especially among the elderly. Over 9 in 10 Americans report using medicines, more than half of Americans report that they are regular users of prescription drugs, almost one-third have more than five prescription drugs in their medicine cabinets, and 1 in 10 spend $1000 or more per year on prescription drugs. Americans have generally favorable views toward generic drugs. Most Americans have seen an advertisement for prescription drugs in the past year, around one-third have talked to a doctor about a specific drug after seeing an advertisement, and 7% of Americans report asking their doctor to prescribe a specific medicine they saw advertised. Compared to other companies and groups, pharmaceutical companies rank near the middle in terms of being seen in a favorable light by the public. However, about three-quarters of Americans believe that pharmaceutical companies, along with tobacco and oil companies, make too much profit.
I. Prescription Drug Use Today Prescription drugs are a mainstay in the lives of many Americans. More than 9 in 10 Americans (91%) report that they have taken prescription drugs, more than half (54%) say they take prescription drugs on a regular basis, and one-fourth (24%) say that they take three or more drugs regularly. Almost one-third (30%) say they currently have more than five prescription drugs in their medicine cabinet. Nearly 1 in 10 (8%) estimate that they spent $1000 or more out of their own pocket on prescription drugs in the past year. (Chart 1) Older Americans are more likely than their younger counterparts to regularly use prescription drugs. Americans over age 65 are much more likely than adults under age 65 to say that they are regular prescription drugs users (82% vs. 49%); that they take three or more prescription drugs regularly (55% vs. 17%); that they currently have more than five drugs in their medicine cabinet (40% vs. 28%); and that they spent $1000 or more out-of-pocket on prescription drugs last year (19% vs. 6%). (Chart 1) Seniors are less likely than younger Americans to have insurance coverage for prescription drugs. One-quarter (25%) of Americans report that they do not have prescription drug coverage through their health insurance plan. Even though older Americans are more likely than younger Americans to use prescription drugs, they are more likely than people under age 65 to report that they do not have any kind of prescription drug coverage (38% vs. 23%). Paying for prescription drugs is difficult for some Americans. Almost 3 in 10 (29%) say they have not filled a prescription because of the cost, one-quarter (25%) say they have to give up other things to buy prescription drugs for themselves or their families, and 1 in 10 (10%) report having to give up basic necessities such as cutting down on food to pay for prescription drugs. More than 1 in 10 (14%) Americans say that paying for prescription medicines they need for themselves or their families is a "serious problem." Among the elderly 16% say they have not filled a prescription because of the cost, about 1 in 5 (21%) say they have had to give up things to buy prescription drugs, and 9% say they have had to give up basic necessities like cutting down on food to pay for their medicines. And, 23% of the elderly say that paying for prescription medicines they need for themselves or their families is a "serious problem." (Chart 2) The public expresses some concerns about being able to pay for prescription drugs and being able to get drugs they need. Six in ten (60%) Americans are "very" or "somewhat worried" that the amount they or their family pay for prescription drugs will increase. Among people with prescription drug coverage, 60% are "very" or "somewhat worried" that their health plan will raise the share they pay directly for drugs, 58% worry that their health plan will not cover a drug that they or their family might need, but fewer (28%) worry that their health plan might require that they or their family use generic drugs instead of brand name drugs. People without prescription drug coverage are more likely than their counterparts to have worries about and problems with paying for prescription drugs, and to have not filled a prescription because of the cost. People without prescription drug coverage are more likely than those with coverage to say they are "very worried" that "the amount you or your family pay for prescription drugs will increase" (33% vs. 23%), that it is a "serious problem" for you or your family to pay for prescription medicines that you need" (28% vs. 9%), and that they have "ever not filled a prescription because of the cost" (40% vs. 25%). (Chart 3) Most people buy prescription drugs at large drug stores or independent
neighborhood drug stores. The elderly are somewhat more likely than
the non-elderly to buy drugs by mail-order. Looking at where people
"often or sometimes" buy prescription drugs, the majority
buy drugs at large drug stores (74%) or independent neighborhood drug
stores (54%), 37% buy directly through their health plan, 11% buy by
mail-order, 6% buy from another country by travelling there or over
the Internet, and 2% buy over the Internet. The elderly are more likely
than the non-elderly to buy drugs by mail-order (20% vs. 10%) and somewhat
less likely to buy at a large drug store (65% vs. 77%). (Chart 4) II. The Debate Over Prescription Drug Coverage for the Elderly The majority of the public correctly recognizes that the traditional Medicare program does not pay for prescription drugs and favors guaranteeing prescription drug coverage to everyone on Medicare. The majority of the public (55%) says that the traditional Medicare program does not pay for prescription drugs for those 65 and older. By comparison, in 1998, far fewer (29%) were aware that Medicare did not pay for prescription drugs for people aged 65 and older. (Chart 5) Over three-fourths (76%) of the public favors guaranteeing prescription drug coverage to everyone on Medicare, even if it means more government spending to pay for it. The public prefers expanding Medicare as opposed to using private insurance plans to help the elderly pay for prescription drugs. Sixty-two percent prefer "expanding Medicare to pay directly for part of prescription medicine costs for people age 65 and over." Thirty-two percent prefer "having the federal government help people age 65 and over to buy private health insurance plans that would pay part of their prescription medicine costs." When presented arguments for and against their stated choice, a slightly smaller majority (56%) continues to prefer expanding Medicare; 33% favor having the government help people buy private insurance plans; 2% favor both options equally; 3% say "neither"; and 6% say "don’t know." Support before and after arguments does not differ between the elderly and non-elderly. (Chart 6) When asked more broadly about which they trust more to provide health insurance coverage to seniors, the public is more likely to prefer the current government-run Medicare program (47%) as opposed to a plan offered through the health care industry (35%) (5% prefer neither; 2% prefer both equally; and 11% say they don’t know or refused to answer). This is a shift from 1998, when around one-third of the public (36%) said they trusted the government-run Medicare program more and 4 in 10 (40%) said they trusted private industry more (4% said neither; 4% said both equally; and 16% said don’t know or refused to answer). The public prefers to help cover prescription drug costs for all seniors as opposed to only low-income seniors. Almost half (49%) of the public prefers helping cover the costs of prescription medicines for all seniors, compared to 38% who prefer covering only low-income seniors (10% would keep things the way they are now and not add a prescription drug benefit, and 3% say they "don’t know"). (Chart 7) Almost a third (31%) of Americans have seen advertisements related
to the debate over whether Medicare should cover prescription drugs.
Fourteen percent said they saw ads that they thought were "for"
covering prescription drugs through Medicare, 5% saw ads they thought
were "against" this, and 6% saw ads both for and against (6%
said they did not know). Only 5% could remember who sponsored the ad
they saw. The elderly were more likely than the non-elderly (38% vs.
30%) to say they saw advertisements related to the prescription drug
debate. III. Regulation of Prescription Drugs About 6 in 10 Americans know that drug prices are rising and that people in other countries pay lower prices than people in this country for the same prescription drug. The majority of the public (62%) knows that over the past five years, the price of prescription drugs has risen "faster than most things" (by comparison, 27% say "about the same"; 5% say "not as fast"; and 6% say "don’t know"). The majority of the public (63%) also knows that, in general, people in Canada, Mexico, and Western Europe pay lower prices for the same prescription drug than people in this country (by comparison, 15% say "higher"; 10% say "about the same"; and 12% say "don’t know"). (Chart 8) The public expresses interest in regulating the price of drugs, though support drops when presented with the argument made by some that says that this will lead to less research and development by drug companies. A majority (60%) think there is not as much regulation as there should be of the costs of prescription drugs, 15% say there is too much regulation, and 19% say there is the right amount of regulation currently. However, when the criticism that limiting prices might lead to less research and development of new drugs is raised to those who initially favored regulation, support drops to 42%, with 16% who originally favored more regulation now believing there should not be more regulation if it would lead to less research and development. (Chart 9) Most Americans favor allowing the importation of lower-priced prescription drugs from other countries, but support falls to half of the public when the argument made by some is raised that this might lead to less research and development by drug companies. Almost 8 in 10 (79%) of the public favors allowing pharmacies and wholesalers to import lower-priced prescription drugs from other countries as long as the safety of those drugs is guaranteed by the FDA. However, this support falls to 50% when the criticism is raised that this might lead to less research and development of new drugs. (Chart 10) The majority of Americans do not see a need for additional regulation of prescription drug safety and of prescription drugs advertisements, although more than one-third of the public would like to see more regulation of these areas. Around half of Americans say there is the right amount of regulation in terms of making sure prescription drugs are safe for people to use, although more than one-third think there should be more regulation (48% say right amount; 36% say not as much as there should be; 12% say too much). Similarly, around half of Americans think there is enough regulation in terms of making sure that statements about benefits and possible side effects made in advertisements for prescription drugs are not misleading, although, again, over one-third would like to see more regulation (51% say right amount; 37% say not as much as there should be; and 8% say too much). Around half of the public is interested in requiring health plans
to pay for brand name drugs when patients or doctors request them, but
less than half are interested if this would lead to higher health insurance
premiums. While a majority of the public says that "health
plans should pay for brand name drugs when a doctor requests them even
if a cheaper generic drug is available" (64%), this support falls
to 40% if it would mean they would have to pay higher health insurance
premiums. Half of Americans (50%) say that "health plans should
pay for brand name drugs when a patient requests them," but this
support falls to 28% if it would mean they would have to pay higher
health insurance premiums. IV. Generic vs. Brand Name Drugs Most of the public thinks generic and brand name drugs are about the same in quality. Eight in 10 people (80%) say that in most cases brand name prescription drugs and generic drugs are "about the same" in quality, compared to 14% who think brand name drugs are "better" and 3% who think they are "worse." (Chart 11) Around half (54%) of the public says that when they get prescriptions filled, they usually get a generic drug. Twenty-seven percent usually get a brand name drug, and 13% usually get both brand name and generic drugs about equally. (Chart 12) Doctors and pharmacists sometimes ask people to get generic drugs
instead of brand name drugs. Getting a generic drug does not make
a difference to people in the majority of cases. Some people report
that they have wanted a particular brand name drug but have had a doctor
ask them to get a cheaper, generic version of that drug (14%). A third
(33%) of the public reports that they have expected a particular brand
name drug but have had a pharmacist ask them to get a cheaper, generic
version of that drug. Among those who have expected a brand name drug
from a doctor or pharmacist but were asked to get a generic drug, 65%
say that getting the generic drug did not make a difference to them,
and 33% say they would have preferred the brand name drug. V. How People Get Information about Prescription Drugs, and the Role of Advertising Most people feel well-informed about prescription drugs. Eighty-seven percent say that they were "very" (55%) or "somewhat" (32%) confident that they had enough information the last time they got a prescription drug they had never taken before. Americans are most likely to trust health professionals for information on prescription drugs, but still about half also say they trust advertisements. When asked about how much they trust different sources to provide accurate information about prescription medicines, people were most likely to say they trust their doctors (95%) and their pharmacists (93%) "a lot" or "somewhat", followed by the information included in packages of prescription medicines (89%), the FDA (80%), and their family and friends (61%). Almost half (48%) say they trust advertisements for accurate information about prescription medicines. The elderly were less likely than the non-elderly to trust advertisements (35% vs. 51%), or family and friends (46% vs. 64). (Chart 13) About 2 in 10 (22%) people have ever looked for information about prescription drugs over the Internet. When asked about a variety of reasons why and when they turned to the Internet for information: 15% of Americans say they had questions about a drug that they thought of after they had already seen their doctor or pharmacist; 8% say they looked on the Internet before they went to see their doctor; 7% say they looked on the Internet because they had questions about a drug that their doctor or pharmacist was not able to answer clearly enough; 4% say it was because they had questions about the drug that they were not comfortable asking their doctor or pharmacist; and 2% say they checked the Internet because wanted to find a cheaper drug. Two in 10 people (20%) "very often" or "somewhat often" get advice from their friends or family about which prescription drugs to take. Sixty-one percent say they "almost never" get advice from friends and family about which prescription drugs to take and 19% say this happens "not very often." The elderly are less likely than the non-elderly (10% vs. 22%) to say they get advice from their friends and family about which prescription drugs to take. Almost all Americans (91%) have seen an ad for prescription drugs in the past year. Eighty-six percent of Americans saw an ad on the TV or radio, and 73% in a newspaper or magazine. Around one-third have seen advertisements for prescription drugs in a letter, flyer, or announcement they got in the mail (33%) or on a billboard (32%), and 15% have seen a drug advertisement on the Internet. The elderly were less likely than the non-elderly to have seen ads on TV or radio (75% vs. 88%), in a newspaper or magazine (65% vs. 74%), on a billboard (19% vs. 34%), or on the Internet (4% vs. 17%). (Chart 14) Around half of those who have seen or heard such advertisements say that they do a good job of informing the public about the drugs advertised. Around half of the public who has seen ads says that these advertisements generally do an "excellent" or "good" job describing potential benefits of the drug (58%), what condition or disease the drug is designed to treat (51%), and describing the potential side effects of the drug (45%). (Chart 15) Prescription drug advertisements sometimes lead Americans to talk
to a doctor about the drug they saw advertised. Around one-third
(34%) of Americans say that they talked to a doctor after seeing or
hearing an ad for prescription drugs, and 7% of Americans asked a doctor
to prescribe a specific drug they saw or heard advertised. (Chart 14) VI. Views of the Prescription Drug Industry Americans are divided in their views about pharmaceutical companies with 48% having a favorable view and 44% having an unfavorable view. People are more likely to have an unfavorable view of tobacco companies (71%), HMOs (57%), oil companies (57%), and health insurance companies (52%) than pharmaceutical companies (44%). However, views of airlines (28%), banks (26%), hospitals (25%), and doctors (17%) are less negative. The elderly are more likely than the non-elderly (52% vs. 43%) to have an unfavorable view of drug companies. (Chart 16) Around three-quarters of the public says that pharmaceutical companies make too much profit, ranking near tobacco companies and oil companies. People are about as likely to say that tobacco companies (76%), oil companies (75%), and drug companies (73%) make too much profit, followed by health insurance companies (68%), HMOs (56%), banks (50%), hospitals (46%), and airlines (33%). The elderly were more likely than the non-elderly (85% vs. 70%) to say drug companies make too much profit. (Chart 16) The public’s attitude towards how well pharmaceutical companies serve consumers has recently become more negative. In 1997, the majority of the public (62%) thought that pharmaceutical companies were doing a "good job" in serving health care consumers in terms of issues such as quality, cost and convenience. Support remained almost as high in 1998 (59%), but dropped to 45% in April of 2000. (Data, from other Kaiser Family Foundation/Harvard School of Public Health surveys). (Chart 17) |
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| Methodology | ||
| The NewsHour with Jim Lehrer/Kaiser Family Foundation/Harvard
School of Public Health National Survey on Prescription Drugs is a product
of an ongoing partnership between The NewsHour with Jim Lehrer and the
Kaiser Family Foundation to improve coverage of health issues. The Foundation
provides financial support for The NewsHour Health Desk, conducts surveys
with The NewsHour and provides background research on certain health-related
issues covered by The NewsHour. The Kaiser/Harvard survey research team,
led by Dr. Mollyann Brodie, Vice President of the Kaiser Family Foundation,
and Professor Robert Blendon of the Harvard School of Public Health worked
with The NewsHour to develop the survey questionnaire and to analyze the
results with The NewsHour maintaining sole editorial control over its
broadcasts on the survey.
The results of this project are based on a telephone survey conducted between July 26 and September 5, 2000, among a randomly selected nationally representative sample of 1,701 adults 18 years or older (1182 adults ages 18-64 and 502 adults ages 65 and older). Fieldwork was conducted by ICR/International Communications Research. The margin of sampling error is +/-3 percentage points. For results based on subsets of respondents the margin of error is higher. Note that in addition to sampling error there are other possible sources of measurement error. Values less than 0.5 percent are indicated by an asterisk (*).
The Kaiser Family Foundation, based in Menlo Park, California, is a nonprofit, independent national health care philanthropy and is not associated with Kaiser Permanente or Kaiser Industries. The NewsHour with Jim Lehrer, which is broadcast on more than 300 PBS stations nationally and by satellite throughout much of the world, is produced by MacNeil/Lehrer Productions. The NewsHour is funded by Archer Daniels Midland, Travelers Insurance, Salomon Smith Barney, the Corporation for Public Broadcasting and PBS viewers. |
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