Confronting affordability and access

Mother standing and holding infant and cell phone

Consumers are aware of the many barriers impacting access to care, but name affordability as their chief concern. While employers and plan sponsors both prioritize affordability and access, there is room for improved coordination.

Mother standing and holding infant and cell phone

Demand for affordability, access and health equity

When asked what they consider to be the top three problems facing the American health care industry today, consumers overwhelmingly note cost-related challenges.

Employers generally share their employees' focus on making the cost of care more affordable and manageable while health plan leaders emphasize obstacles like bureaucracy and mental health stigma.

The greatest problems facing the American health care system:



The cost of insurance and premiums increasing



The cost of insurance and premiums increasing

The cost of prescription drugs is too high


Consumers look to employers for help

In addition to ensuring affordability, consumer respondents are clear in their expectation that employers ensure a flexible, supportive culture that prioritizes well-being, as well as benefits that meet their needs-- such as paid sick leave, flexible schedules that allow time for care and convenient access to providers.

Consumers' expectations of their employers in terms of improving access to health care

Consumers' top expectations from employers:


ensuring health care premiums are affordable


offering paid sick leave benefits


ensuring out-of-pocket health care costs are manageable

Generic medications can reduce costs

Generic medications offer a powerful solution to address both consumers' concerns and the rising cost of prescription drugs. Over the last several decades, generics have entered the mainstream and physicians are almost universally comfortable prescribing them.

40% prefer generic medications, over 33% who prefer name brand

71% are concerned about the unaffordable cost of prescription drugs

95-97% say they are likely to switch to a generic medication if recommended by a physician or because they are just as safe or as effective as the name brand.

Man with holding 2 bottles of prescription medication

savings with many biosimilars over their reference product.

Biosimilars offer promise in the effort to address pharmaceutical costs

Biosimilar medications are safe, clinically equivalent drugs that closely resemble existing biologic products. By introducing competition into the pharmaceutical market, biosimilars can lower costs dramatically. With many biosimilar drugs slated for release in 2023 and beyond, plan sponsors anticipate better health outcomes, greater access to care and lower costs for consumers. 

Challenges in addressing healthy equity

69% of employers and 53% of health plan leaders identify four or more ways their organization can contribute to health equity. However, both employers and health plan leaders say they are overwhelmed by the sheer breadth of health equity challenges impacting consumers.

Plan sponsor's top health equity challenges


Plan sponsors have made efforts to reduce barriers to health

—especially rising costs— and understand they have a role in addressing and supporting access to care.

In order to maximize the potential of generic and biosimilar drugs,

it will be important to educate both consumers and providers about these new drugs' availability and value.

Both employers and health plan leaders view health equity as a standalone strategy,

with health care as the top area where they believe they can have an impact.

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Accredo's Therapeutic Resource Centers deploy a diverse team of pharmacists, nurses, dietitians and social workers to enhance equity and provide high-touch, personalized support for those navigating complex specialty conditions.
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Meghan Pasiczynk smiling

"At Accredo, our core model features services to address health inequity..."

"... including social workers and dietitians on staff, medication labels in braille and so many more. We recently launched a social determinants of health survey to better match patients with the resources that will help them fulfill their potential for health and well-being.”

Meghan Pasiczynk

Vice President, Accredo, Product + Strategy

Harold Carter smiling

“We understand what it means for a patient to afford a drug..."

"... and what plan sponsors are doing to create an equitable benefit. We're at the crossroads of that information, allowing us to bring those parties together to ensure that the appropriate messages are being heard. We'll continue to do that, on behalf of and in partnership with our plan sponsors, as more competition comes in the marketplace due to biosimilars.”

Harold Carter

Senior Vice President, Express Scripts

Pharma Trade Relations