Rising Medication Costs: Leaving Low-Income Individuals Behind

Rising Medication Costs: Leaving Low-Income Individuals Behind

Introduction

Even though medicine can effectively treat many chronic illnesses, we ignore the fact that thousands of residents in New York City still face serious health risks due to its unaffordability. Cost-related nonadherence (CRN) affects individuals with chronic illnesses, with approximately 15% of patients reporting that they have skipped or delayed medication due to its cost. These financial barriers specifically affect low-income individuals where rising medication prices force them to choose between paying for medications or affording basic necessities (Narain et al., 2022).

Research has shown how “the notion of affordability could be further enriched with the addition of an opportunity measure to more fully reflect the true costs of location for the wellbeing of children” (Acevedo-Garcia et al., 2016). This explains how CRN is not solely just an individual issue but is shaped by the underlying social and economic factors. As medication costs continue to rise, low-income individuals in NYC not only face growing health risks that are shaped by economics but also by social and cultural barriers to healthcare access.

Structural Inequality and Forced Trade-Offs

Rising medication costs force low-income individuals to make trade-offs between healthcare and basic necessities, which can greatly affect health behaviors that are largely beyond one's control. Researchers explained how “Medication non-adherence due to costs is an important driver of this socioeconomic gradient in diabetes outcomes,” highlighting how small copayments can accumulate and create a massive financial barrier for low-income individuals. When these costs add up, it can “...pose a financial burden for individuals with low incomes, forcing tradeoffs between medical care and basic necessities.” This demonstrates how this issue does not reflect just personal irresponsibility; in reality, the problem is rooted in unequal healthcare systems (Narain et al., 2022).

Additionally, research has shown “when faced with high housing-cost burdens, families are forced to make tradeoffs between paying for housing and paying for food, health care, and other resources vital to children” (Acevedo-Garcia et al., 2016). This shows how housing costs already create a substantial, disproportionate burden, on top of which healthcare spending becomes one of the first sacrifices—reinforcing the idea of how affordability for medication is tightly bound to one's social and economic status.

Furthermore, another study showed how “higher out-of-pocket costs, lower household income, and lack of drug insurance were the most frequently reported independent predictors of CRNA” (Holbrook et al., 2021). This evidence demonstrates how financial instability directly correlates with the likelihood an individual will skip or reduce their intake of essential medication. These trade-offs show how individuals in marginalized urban communities are often forced to make more severe health-related decisions due to unequal social conditions.

Research has also shown how individuals with insurance are still battling financial barriers, as “the median out-of-pocket cost in 2019 was $3630,” which is “a 41% increase” compared to 2009 (Zhou et al., 2022). This sharp increase shows how the growing inflation cost of medication can disproportionately affect low-income individuals, causing CRN rates to steadily increase over time.

Neighborhood, Culture, and Access to Care

Neighborhood environments and cultural backgrounds play an important role in access and affordability to healthcare and medication. Low-income individuals often face barriers that are not based on personal responsibility, but rather because of systemic inequalities. Research has shown how “concerns regarding effectiveness and negative impact of diabetes medication were prevalent and expressed by 13 (48%) of 27 participants. Dissatisfaction with ineffective provider communication and not being able to pay for medication were other important barriers to adherence and were expressed by 7% and 11% of participants...” (Baghikar et al., 2019). This evidence shows how financial barriers combined with poor communication from providers can limit medication adherence, proving that cultural and social factors significantly shape health behaviors in low-income communities.

Additionally, research has shown how “...children from low‐income neighborhoods undergo more liver biopsies than other children… children living in socioeconomically disadvantaged neighborhoods have increased rates of medication nonadherence, graft failure, and death” (Gutierrez et al., 2024). This directly supports the argument that children in low-income neighborhoods face higher medical risks due to the social and environmental factors individuals encounter.

Furthermore, research has shown how affordability cannot be measured solely by immediate costs, noting that “these hidden costs may also be passed on to other sectors such as education and health” (Acevedo-Garcia et al., 2016). This evidence explains how neighborhood environments play a major role in affecting the long-term consequences of healthcare access among low-income individuals.

Other factors, such as food insecurity and a lack of support from family, can further limit healthcare access in marginalized low-income communities. Research has explained how “food insecurity is a critical social determinant of health that is associated with low income… Previous studies have shown that low-income families may postpone their medical needs or underuse healthcare services in order to prioritize food spending due to budgetary limitations” (Kasper et al., 2024). This directly shows how economic instability prevents individuals from taking necessary medications or treatments.

Additionally, research comparing the impact of cost on treatment decisions established that “medicine was considered affordable if 1 month’s treatment cost less than 1 day’s wage of the lowest paid government worker” (Plum et al., 2025). This explains that even when medications are structurally available, their retail cost limits the ability of low-income individuals to make healthy choices.

Worsening Social Disadvantage and Health Crises

Additional health crises can worsen financial and social pressures, which in return creates poorer medication adherence. Patients with chronic conditions who face new diagnoses often experience a sharp decline in adherence. Researchers have shown from a report that “patients newly diagnosed with cancer who had hyperlipidemia experienced a 7-percentage point to 11-percentage point decrease in the percentage of days covered compared with patients without cancer,” while also experiencing much higher overall medical expenditures (Spees et al., 2020). This explains how unexpected health events further exhaust a patient's ability to consistently buy and take the medication they need. Research has shown that even when medications become more affordable through generic alternatives, high out-of-pocket costs for brand-name drugs continue to create profound financial strains (Zhou et al., 2022).

These substantial disadvantages heavily contribute to long-term health disparities in low-income communities. Research has shown how low-income families face hidden costs such as poorer health, reduced child development, and a decrease in future earnings. Conversely, positive policy implementations have shown potential to correct these trends; research notes that “DHP-exposure was associated with an 8.2 percentage point increase in medication adherence among beneficiaries with low baseline medication adherence,” demonstrating how tailored policy programs can successfully reduce barriers to adherence for financially unstable individuals (Narain et al., 2022).

However, cost-related nonadherence (CRN) remains a major, fatal issue. Research has shown how “CRN was associated with 15% to 22% higher all-cause mortality rates for all conditions” and “on average, 15% of the sample reported cost-related nonadherence,” which simply shows how individuals frequently skip or delay their medication due to sheer unaffordability (Van Alsten & Harris, 2020). This evidence proves that financial and social disadvantages do not just limit medication adherence for individuals on a daily basis, but also directly link to worsened mortality health outcomes, highlighting the urgent need for price regulations in low-income communities.

Conclusion

Rising medication costs significantly affect low-income areas in New York City by making it difficult for individuals to access and consistently take the essential medication they need. From a social perspective, this argument plays a major role in discussing how cost contributes to greater health inequalities between low- and high-income areas. From a cultural perspective, this argument explains how financial barriers can reduce overall trust in healthcare systems and lead individuals to delay, skip, or reduce their medication intake altogether. By addressing this issue through the lenses of social and cultural factors that influence adherence—such as housing costs, medication pricing, and structural resource allocation—we can promote effective systemic solutions that improve health outcomes and reduce inequalities within low-income families.