What is copay abandonment?

November 12, 2025

Summary

Copay abandonment occurs when patients do not pick up their prescribed medications with rates increasing sharply as drug costs rise.
Medication non-adherence due to copay abandonment can lead to serious health consequences, including increased hospitalizations, deaths, and nearly $300 billion in annual healthcare costs in the U.S.
High prescription costs disproportionately affect lower-income and medically underserved populations, causing many to skip filling prescriptions or sacrifice other essential expenses.

Introduction

Copay abandonment, also known as prescription abandonment, is when a patient does not pick up their prescription from a pharmacy, resulting in the patient not taking their medication. There are numerous implications for patients and the healthcare system when copay abandonment occurs.

Why do patients abandon their prescriptions?

A 2020 report from IQVIA, a provider of clinical research services, commercial insight, and healthcare intelligence for life science and healthcare companies, indicated that about 9% of all new prescriptions are abandoned. That percentage changes according to the price of the drug. For drugs at no cost to the patient, the rate was 5%. But for a drug that costs $500 or more, the rate was 60%.

Recent research from KFF shows that about three in 10 people have not taken their prescription medicine due to cost. And about 21% of those people did not even fill their prescription to begin with.

Since 2014, prices for prescription medicines have risen about 37%, and the average American spends over $16 for a prescription. Copay amounts are also rising as are deductibles, so patients are becoming responsible for more costs. People with high-deductible health plans have been found more likely to abandon their prescriptions.

Specialty medications are often more expensive than other types of medications. Less than 5% of patients take specialty medications, but those who do may be more likely to abandon their prescriptions because of the expense. Spending on specialty drugs went from $211 billion in 2016 to $301 billion in 2021. The average price of a specialty medication per member per year in 2024 was $1641, an increase of over $300 from the cost in 2023.

High prescription costs can make patients forego other expenses in their lives like housing, utilities, clothing, food, and childcare. Higher prescription costs hit lower income people and those from medically underserved areas harder. People from underserved areas abandon their prescriptions at a higher rate than others—5.44% compared to 4.77%.

What are the effects of copay abandonment?

The cost of copay abandonment and resulting medication non-adherence is significant. While copay abandonment might help patients in the short term, there could be greater costs and ripple effects down the line.

Without proper medications, patients may have reduced quality of life and issues with daily functioning. Additionally, their health can deteriorate, and they can experience negative health outcomes, which may require more treatment later. This could include emergency room visits and even hospitalizations.

Medication non-adherence causes one in 10 hospitalizations and about 125,000 deaths per year. It also costs the healthcare system in the U.S. almost $300 billion annually.

Healthcare providers may also experience increased costs and greater demand from these patients.

How can you reduce copay abandonment?

One way to reduce copay abandonment is with copay assistance. A study from 2023 showed that patients with rheumatoid arthritis who received copay assistance were almost 80% less likely to abandon their medicines. Patients with cancer were 71% less likely to abandon their oral anti-cancer drugs.

Copay assistance helps patients pay for their prescriptions and stay on track with their medications. This, in turn, can keep them healthier and potentially lower healthcare costs for all involved.

How does VytlOne help patients?

We support rare disease patients by assigning a dedicated case manager to facilitate copay assistance as well as foundation assistance to remove financial barriers. We also partner with industry-leading experts to ensure our team has the most up to date and timely assistance available for patients.

We support PBM members through clinical programs, including Dynamic Discounts, powered by Sempre Health. Dynamic Discounts improves medication adherence by rewarding members with lower copays when they exhibit good behaviors, like filling chronic disease prescriptions consistently and on time.

Final thoughts

Copay abandonment presents a significant challenge: affecting patient health, driving up healthcare costs, and straining providers. However, effective solutions like copay assistance and clinical programs offer a path forward, helping patients stay adherent to their medications and improving overall outcomes.

By removing financial barriers and supporting both patients and providers, organizations, including VytlOne, are making strides to address this complex issue, working toward better access to care and healthier futures for those in need.