Prescription drug insurance coverage and patient health outcomes: a systematic review

Am J Public Health. 2015 Feb;105(2):e17-30. doi: 10.2105/AJPH.2014.302240.


Previous reviews have shown that changes in prescription drug insurance benefits can affect medication use and adherence. We conducted a systematic review of the literature to identify studies addressing the association between prescription drug coverage and health outcomes. Studies were included if they collected empirical data on expansions or restrictions of prescription drug coverage and if they reported clinical outcomes. We found 23 studies demonstrating that broader prescription drug insurance reduces use of other health care services and has a positive impact on patient outcomes. Coverage gaps or caps on drug insurance generally led to worse outcomes. States should consider implementing the Affordable Care Act expansions in drug coverage to improve the health of low-income patients receiving state-based health insurance.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't
  • Review
  • Systematic Review

MeSH terms

  • Humans
  • Insurance Coverage / statistics & numerical data
  • Insurance, Pharmaceutical Services* / statistics & numerical data
  • Patient Outcome Assessment
  • Patient Protection and Affordable Care Act
  • Prescription Drugs / economics
  • Prescription Drugs / therapeutic use
  • United States


  • Prescription Drugs