The Impact of Job and Insurance Loss on Prescription Drug use: A Panel Data Approach to Quantifying the Health Consequences of Unemployment During the Covid-19 Pandemic

Abstract

Due to the nature of health insurance in the United States, health care utilization is often tied to economic conditions, at both the individual and aggregate levels. This article examines how loss of employment may reduce medication adherence through the subsequent loss of insurance and income. At the individual level, the loss of employer-sponsored insurance is shown to be associated with lower prescription drug use and higher out-of-pocket expenditures. The rapid increase in unemployment during the COVID-19 pandemic provides a natural experiment to estimate the causal relationship between unemployment and prescription drug use at the aggregate level. In total, the growth in unemployment during the pandemic resulted in a 2.6% reduction in medication adherence and 57.5 million fewer prescriptions filled in 2020, with prescriptions declining for many chronic conditions. Unemployment-related reductions in prescription fills and medication adherence were highest in states without expanded Medicaid eligibility, further underscoring the importance of social safety nets such as Medicaid during times of economic hardship.

Managing Medications and Medication Adherence Among US Adults During the Early Phase of the COVID-19 Pandemic

“…The unemployment rate reached an all-time high of 14.8%, and more than 25 million Americans lost their health insurance. 12 …”

“…The unemployment rate reached an all-time high of 14.8%, and more than 25 million Americans lost their health insurance. 12 The unprecedented disruptions brought on by the pandemic made managing and adherence to medications more complex. Several studies have investigated the effects of the pandemic on nonadherence.…”

A multinational Delphi consensus to end the COVID-19 public health threat

“…Furthermore, long-standing social inequities have caused some populations to experience greater risk of COVID-19 infection, severe disease and death 37 . Many of these populations continue to have less access to COVID-19 vaccines 37,49 and treatment 39 , as well as to resources to mitigate the mental health, social and economic consequences of the pandemic [50][51][52] .…”

Medical Expenditures Associated with Attention-Deficit/Hyperactivity Disorder Among Adults in the United States by Age, 2015–2019

“…Employment status has a significant impact of healthcare utilization and costs, with unemployed individuals less likely to visit physicians for preventative services and less likely to fill prescriptions. 47,48 This impact may be even greater in individuals diagnosed with ADHD, as ADHD medication can be expensive and often requires frequent visits to the physician for proper management. 49,50 By including all adults, regardless of insurance or employment, our findings allow for a more complete understanding of the financial impact of ADHD in adults.…”