More than one‑third of American adults say they have altered how they obtain prescription medication because they are unsure of the price they will face at the pharmacy counter, according to a new survey from Model N. The research shows that 35% of respondents reported delaying a fill, leaving a pharmacy without the drug, or taking a smaller dose than prescribed due to unclear cost information.

Survey details and national impact

The Model N poll also revealed that 46% of U.S. adults do not consistently know how much a prescription will cost before arriving at the pharmacy. This lack of transparency affects everyday families who rely on essential medicines, from blood‑pressure pills to life‑saving insulin.

Insulin users are especially vulnerable. The American Diabetes Association recently reported that nearly 40% of insulin‑dependent patients pay more than $150 per month for the hormone, a burden that can force difficult choices about other household expenses.

Pharmacy benefit managers under scrutiny

Pharmacy benefit managers (PBMs) – entities that negotiate with drug manufacturers, create formularies and secure rebates for health plans – are at the center of the debate. The Model N survey found that 76% of respondents either had never heard of PBMs or had heard of them but did not understand their role.

State officials are taking action. Florida has filed lawsuits against several major PBMs and insulin manufacturers, alleging that pricing and rebate practices have driven up costs for diabetes medications. In Iowa, the state is challenging a court decision that blocked portions of a law intended to regulate PBM activities.

Industry response and proposed reforms

Paul Pruitt, co‑founder of prescription‑drug procurement firm SHARx, argues that PBM compensation should be separated from medication prices. He suggests that pharmacy benefits be measured by affordability, access and medication adherence rather than by the size of rebates.

Advocates for patients say greater price transparency would empower families to make informed decisions and avoid harmful medication gaps. When patients cannot predict out‑of‑pocket costs, they may skip doses, jeopardizing health outcomes and increasing long‑term health‑care expenses.

What families can do

While policymakers and industry leaders work toward clearer pricing structures, families can take practical steps to protect themselves. Asking health‑plan representatives for cost estimates, using price‑comparison tools, and discussing generic alternatives with physicians are proven ways to reduce surprise bills.

Community health clinics and pharmacy‑based counseling programs also offer resources to help patients navigate medication costs. By staying informed and advocating for transparent pricing, families can safeguard both their health and their household budgets.

Looking ahead

The Model N findings underscore a growing national conversation about how prescription‑drug pricing transparency—or the lack thereof—affects everyday Americans. As state attorneys general continue to examine PBM practices and lawmakers consider regulatory reforms, the hope is that clearer information will lead to better medication adherence, healthier families, and a more affordable health‑care system.

Original reporting: WOWO News/Talk (Fort Wayne) — read the source article.