Model N Survey Shows 35% Delay Prescriptions Due to Uncertain Costs

REDWOOD CITY, Calif., Sept. 23, 2026 /CourierPR/ -- In a new survey conducted by Model N, a leading end-to-end commercialization, revenue optimization, and compliance platform for life sciences companies, nearly one in three U.S. adults (35%) reported that not knowing what a prescription would cost led them to delay picking up their medication, leave the pharmacy without it, or stretch their medication by skipping or reducing doses to make it last longer. The survey, conducted in August 2026, found that 46% of respondents do not consistently know what a prescription will cost before reaching the pharmacy. Overall, 58% have taken at least one cost-containment action because of price uncertainty.

The survey revealed that 72% of respondents have used at least one method to check prescription prices. These methods include calling or asking a local pharmacy, searching a price-comparison site or app, and checking with an insurance company. Two in five respondents (40%) said they are now more likely to check prescription prices before picking up their medication compared to a year ago. However, awareness of manufacturer programs designed to help patients afford or stay on their medication, such as co-pay assistance, remains low. About 65% of respondents have not looked into these offerings, and 39% did not even know they exist. Only 19% said they have used one.

The findings also show that most patients have limited visibility into the coverage and pricing decisions that ultimately determine what they pay for medications. Nearly half of respondents (46%) said expected prescription costs influenced a treatment decision, with outcomes including choosing a lower-cost medication, not starting a drug treatment, asking about other treatment options, and asking about ways to lower the cost. Patients are becoming more active prescription price shoppers, with 72% of respondents having used at least one method to check prescription prices.

The survey also highlighted that three significant themes emerged from this research. Prescription price uncertainty is changing medication decisions, with 46% of respondents stating that expected prescription costs influenced a treatment decision. Patients are also becoming more active prescription price shoppers, with 72% of respondents having used at least one method to check prescription prices.

The research also revealed that most patients have limited visibility into the coverage and pricing decisions that ultimately determine what they pay for medications. When asked which factors have the biggest impact on what they pay for a prescription, 62% of respondents selected health insurance coverage, including copays or deductibles. Many of the behind-the-scenes factors that influence prescription costs and patient access remain poorly understood. Only 18% selected intermediaries that work with insurers and pharmacies as having an impact on prescription costs. The survey also showed that most people know very little about these entities; 76% had either never heard of pharmacy benefit managers (PBMs) or had heard of them but did not know what they do.

PBMs are one of several factors that influence prescription drug coverage and pricing. Model N's 2026 State of Revenue Report found that 99% of life sciences leaders say gross-to-net has become more complex. PBMs were the most commonly cited contributor to that complexity, selected by 61% of respondents. Patients often see the effects of coverage decisions through the formulary, the health plan's list of covered medications that can affect patient access and out-of-pocket costs. Through their role in managing pharmacy benefits, PBMs influence coverage decisions, including formulary placement. When formulary details are inaccurate or outdated, this can create confusion for patients and challenges for providers and pharmacies.

For manufacturers, that awareness gap creates an opportunity to make other access options and programs that help with medication costs easier for patients to find. Coverage and pricing dynamics remain unclear to many patients, with 62% of respondents selecting health insurance coverage as the biggest factor influencing prescription costs. Only 18% selected intermediaries that work with insurers and pharmacies as having an impact on prescription costs. The survey also showed that most people know very little about these entities; 76% had either never heard of pharmacy benefit managers (PBMs) or had heard of them but did not know what they do.

For manufacturers, the stakes are high when affordability or coverage issues prevent a patient from filling a prescribed therapy or lead to a different treatment choice. That makes it important to negotiate favorable formulary positions and ensure rebates tied to those agreements are administered accurately. Model N's Payer, Validata, and Formulary Compliance solutions are purpose-built to support those efforts.