Drug Costs: Flexible Payment Plans?
- A meaningful portion of prescriptions go unfilled or are taken incorrectly, according to the Centers for Disease Control and Prevention.
- Research indicates a strong link between medication costs and patient adherence.
- A Penn Medicine study from April 2025 highlights the impact of "time-to-pay" solutions.
Time-to-Pay Plans Expand Access to Healthcare
A meaningful portion of prescriptions go unfilled or are taken incorrectly, according to the Centers for Disease Control and Prevention. Experts say that focusing solely on coverage and price isn’t enough. The ability to pay over time is a crucial element in making healthcare truly affordable.
Research indicates a strong link between medication costs and patient adherence. A 2017 study revealed that abandonment rates for oral anticancer prescriptions jumped to 41% when out-of-pocket expenses ranged from $501 to $2,000, and nearly 50% for costs exceeding $2,000.
A Penn Medicine study from April 2025 highlights the impact of “time-to-pay” solutions. In 2023, Medicare Part D patients faced costs of $11,000 to $20,000 for oral anti-cancer drugs. By 2025, those costs are capped at $2,000. The Medicare Prescription Payment Plan (M3P) allows patients to spread that $2,000 over 12 monthly installments of $167. Given that the average Social Security check is $1,999, M3P makes these medications far more accessible.
The “time-to-pay” concept is gaining traction beyond Medicare.Commercial health plans are increasingly offering similar options.
- Choice Health Plans: Some plans pay providers upfront and then bill patients in installments.
- Health Payment Accounts (HPAs): These accounts allow cardholders to pay medical expenses and convert them into interest-free repayment plans, often managed through payroll deductions.
These models benefit both patients and providers. Patients gain access to needed care without crippling upfront costs, while providers receive prompt and full payment, reducing administrative burdens. This can lead to payers negotiating more favorable rates.
while efforts to lower drug prices are essential, integrating “time-to-pay” options into health benefit design is becoming increasingly necessary to expand access, improve affordability, and promote better outcomes.
What’s next
Payers should integrate “time-to-pay” options into 2026 plan designs and encourage enrollment.Providers should leverage these options to help patients start and stay on essential therapies, improving medication adherence and overall health.