maintaining health insurance is a key protection against unmet need for prescription drugs in a nationally representative sample. However, having insurance does not guarantee coverage completeness or access to care. Patient cost sharing is increasing through higher deductibles, copayments, and coinsurance rates4 and medical financial hardship is increasingly documented in the United States,5 especially in relation to prescription drug use. Although findings were robust in sensitivity analyses, the study was limited by self-reported measures and lack of cost-sharing information. Self-reported unmet need may not correspond exactly to objective clinical measures. Prescription drug spending is projected to continue rising,1 increasing fiscal pressures on commercial, federal, state, and family budgets. For individuals with high drug costs, these trends may erode some of the protective effect of insurance coverage documented in this study. It is therefore imperative that research continue to monitor the relationship between insurance coverage and unmet need, assess spending and clinical outcomes, and that survey, administrative, and clinical data be available to do so.

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2010-2016年医学教育债务分专业分布

在具有全国代表性的样本中，维持健康保险是防止处方药需求未得到满足的关键保护措施。但是，拥有保险并不能保证承保范围的完整性或获得护理的机会。通过更高的免赔额、共付额和共同保险费率 4，患者成本分摊正在增加，并且在美国，医疗财务困难的记录越来越多，尤其是在处方药使用方面。尽管敏感性分析的结果是稳健的，但该研究受到自我报告措施和缺乏成本分摊信息的限制。自我报告的未满足需求可能与客观的临床测量不完全对应。处方药支出预计将继续增加，1 增加商业、联邦、州和家庭预算的财政压力。对于药物成本高的人，这些趋势可能会削弱本研究中记录的保险范围的某些保护作用。因此，研究必须继续监测保险覆盖范围与未满足需求之间的关系，评估支出和临床结果，并提供调查、行政和临床数据来做到这一点。