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Prescription Drug Spending Around the U.S.

As healthcare costs continue to climb for many Americans, prescription drugs are no exception. Find out which states spend the most on Rx medications here.

A header image for a blog about prescription drug spending in the U.S.

The U.S. has outpaced comparable countries when it comes to prescribed medicine spending by a generous amount and has seen a continued increase in those costs over the years. Given the severe expenditure Americans face when it comes to prescription medication, we wanted to take a closer look at prescribed medicine spending in the U.S. 

In this study, Assurance leveraged the most recently available data from KFF.org to find out the states whose residents spend the most on prescription drugs. The data that follows reflects prescriptions filled both in pharmacies and via mail order and is frequently positioned per person to allow for more accurate comparisons to be made between states. The spending data includes prescriptions covered by commercial payers, some government programs, Medicare, Medicaid, and cash payments.

Key Findings

  • The statewide average for prescription drug spending overall is $10.8 billion. The average per person was $1,711.52.
  • The state that spends the most overall on prescription drugs is Texas at $45.6 billion. The state that spends the least overall is Wyoming at $779.5 million.
  • The state that spends the most on prescription drugs per person is Iowa at $4,084.16. The state that spends the least is Indiana at $650.60.

Mapping Prescription Drug Spend Around the U.S.

A U.S. map showing the states that spend the most on prescription drugs

On average, many U.S. states spend between $1,300 to $1,900 on prescription drugs per resident. The South spends more on prescription drugs than other regions in the country at just over $1,800 per person. Midwesterners and Americans in the Northeast are right behind the South in prescription spending per resident at just over $1,700 apiece. The West had the lowest prescription drug sales per person at just $1,362.05.

Indiana spends less than anywhere else in the country on prescription drugs at only $650.60 per resident. It has many free assistance programs, such as Hoosier Rx and Indiana Drug Card, to help patients get access to their prescriptions for less. With the Indiana Drug Card, residents in Indiana typically receive discounts between 30% and 80%, depending on what medicine they need.

In contrast, Iowans spend more than any other state on prescription drugs. Iowa had the highest prescription sales per person at $4,084.16. In mail-order prescription sales alone, Iowa spends $1,182.91 per resident, rivaling many other states’ total prescription drug sales. California, a state whose population size is nearly 12 times greater than Iowa’s, only spends $1,138.80 per person on prescription medication.

States Spending the Most on Their Medications

Bar charts showing the states that spend the most and least on prescription drugs.

Iowans spend the most on prescription drugs in the pharmacy lines and via mail-order compared to any other state in the country. Unsurprisingly, Texas and California spend the most on prescription drugs in total at over $40 billion each, primarily due to their population size. However, their total spending per person was relatively tame at just over $1,100 and $1,500, respectively. Meanwhile, Delaware and Kentucky were just behind Iowa in prescription sales per resident at barely above $2,300 each.

Closing Thoughts

As healthcare costs continue to climb for many patients in the U.S., prescription drug prices follow suit. According to our study, residents in the South and Midwest face more challenges when it comes to affording prescription medications. Prescription drugs are a big part of health care for people all over the country, and a costly one at that. At Assurance, you can shop and compare health insurance plans to find the one that works best for you to try and cut down on the cost of things like prescription drugs.

Methodology

To determine the states that spend the most and least on prescription drugs, we pulled the most recent data available (2019) from the Kaiser Family Foundation (KFF) on prescription drug spending and prescriptions filled by state. We then mapped out what prescription drug spending looks like around the U.S. We found the states that spend the most and least overall and per person to get a better view of the landscape as a whole.

Our data reflects prescriptions filled both in pharmacies and via mail order. The spending data includes prescriptions covered by commercial payers, some government programs, Medicare, Medicaid, and cash payments.