Executive Summary 

Prescription drug costs are a significant concern for many Virginia residents. Findings from Altarum’s Consumer Healthcare Experience State Survey (CHESS), conducted among more than 1,300 Virginia adults from July 9 to July 16, 2026, highlight widespread medication rationing due to cost, high levels of worry about affording needed prescriptions, and broad support for government action to address these challenges.

Key findings include:

• Medication rationing due to cost is not uncommon: A quarter of respondents (25%) reported cutting pills, skipping doses, or not filling a prescription due to cost.
• Medication rationing varies across groups: Rates of rationing differed by household income, insurance coverage, and other respondent characteristics.
• Worry about affording prescription drugs is widespread: Nearly half of respondents (44%) reported being worried that they or a family member living with them would not be able to afford needed prescription drugs.
• Support for policy solutions is strong and bipartisan: Respondents across political affiliations expressed support for policies to lower prescription drug prices and reduce out‑of‑pocket costs.

Together, these findings show that prescription drug affordability remains a pressing concern for many respondents, with real implications for how medications are used. At the same time, there is broad public support for efforts to reduce prescription drug costs and improve affordability.

Background

Prescription drugs are an essential part of health care for many individuals and families. National data indicate that nearly seven in every ten American adults (69%) are prescribed at least one medication,¹ making affordability an important consideration for a large share of the population.

At the same time, prescription drug prices in the United States are substantially higher than in other high‑income countries, contributing to ongoing concerns about access and affordability. Prescription drug prices in the United States are nearly 2.8 times higher than the prices in other OECD countries, like Canada, Japan, and France.² High drug costs can affect whether people are able to obtain and use medications as prescribed, particularly for conditions that require ongoing or long-term treatment.

This brief uses data from Altarum’s Consumer Healthcare Experience State Survey (CHESS) to examine Virginia residents’ experiences with prescription drug affordability, including medication rationing due to cost, and concerns about affording needed prescriptions. It also explores views on policy approaches aimed at addressing high prescription drug costs. Methods and participant characteristics are described in the Appendix.

Medication Rationing

A quarter of Virginia respondents (25%) reported rationing medication due to cost concerns in the last year. Among those, 13% reported cutting pills in half or skipping a dose, and 18% reported not filling a prescription due to cost concerns (Figure 1).

Figure 1. Percent of Respondents that Did Not Fill a Prescription, Cut Pills in Half, or Skipped a Dose of a Prescription Medication due to Cost Concerns in the Last Year

Source: 2026 Poll of Virginia Adults, Ages 18+, Altarum Healthcare Value Hub’s Consumer Healthcare Experience State Survey

Medication rationing varies across respondent groups in Virginia (Table 1). Differences were observed by household income, insurance coverage type, and other respondent characteristics, underscoring that cost-related barriers to obtaining prescription drugs affects multiple populations. National evidence similarly indicates that medication rationing and access barriers persist across income and insurance status, including among insured individuals.³

While some patients may attempt to manage high drug costs through secondary coverage, paying out-of-pocket, or manufacturer coupons, these approaches are not sufficient for many. Nearly half (44%) of survey respondents reported being somewhat or very worried that they or a family member living with them would not be able to afford the prescription drugs they need. This helps explain why 30% of survey respondents identified reducing out-of-pocket prescription drugs costs as a priority for government action.

Why This Matters

When prescription drugs are unaffordable, patients may ration medications by skipping doses, splitting pills, or not filling a prescription. Prior research shows that medication rationing is associated with worse health outcomes and higher health care use,⁴ highlighting the potential impacts of cost-related medication nonadherence.

Table 1. Percent of Respondents Rationing Medication due to Cost, By Geographic Area, Coverage Type, Demographic Characteristics

Source: 2026 Poll of Virginia Adults, Ages 18+, Altarum Healthcare Value Hub’s Consumer Healthcare Experience State Survey
Note: The Respondents of Color category reflects the combined responses from survey participants who are Black or African American, Hispanic or Latino, American Indian or Alaskan Native, Asian, Native Hawaiian or Other Pacific Islander. The response rate for one or more of those demographic categories was not sufficient to report reliable estimates.
* The sample size for unemployed respondents was 60. The Coefficient of variance for unemployed and cut pills in half or skipped a dose was .4. Please interpret data with caution.  

Respondent Perceptions of Health Care Systems, Policy Solutions

Virginia respondents most often identified drug companies as a driver of rising health care costs (72%). Support for action was even stronger: 91% of respondents favored policies to limit the price of prescription drugs, and 90% supported efforts to prevent rapid prescription drug price increases in the commercial market. These findings suggest that prescription drug affordability is a common concern among respondents and support to address issues cuts across political affiliation, demonstrating broad, bipartisan agreement that policymakers should take meaningful steps to make prescription drugs more affordable (Table 2).

Table 2. Percent of Respondents that Agreed or Strongly Agreed that the Government Should Employ Select Strategies, by Political Affiliation

Source: 2026 Poll of Virginia Adults, Ages 18+, Altarum Healthcare Value Hub’s Consumer Healthcare Experience State Survey

Conclusion

Findings from the Virginia Consumer Healthcare Experience State Survey show that prescription drug costs remain a significant concern for many respondents. More than one in four respondents reported rationing medications due to cost, and more than half reported worry about being able to afford the prescription drugs they or a family member living with them need. Together, these findings highlight the financial pressures associated with prescription drug costs and the ways these pressures can affect how people use needed medications.

At the same time, respondents across political affiliations express strong support for policy approaches aimed at lowering prescription drug prices and reducing out‑of‑pocket costs. Ongoing, state‑level survey data can help policymakers, advocates, and other stakeholders track trends in prescription drug affordability over time and assess whether efforts to address these concerns are improving patients’ experiences.

For more detailed information about health care affordability burdens facing Virginia respondents, please see Healthcare Value Hub, Virginia Residents Struggle to Afford High Health Care Costs; Worry About Affording Health Care in the Future; Support Government Action across Party Lines, Data Brief (October 2026).

Notes

1. NCHS Data Query System. (2024). Prescription Medication Use Among Adults [Internet]. Hyattsville (MD): National Center for Health Statistics. https://www.cdc.gov/nchs/dqs

2. Mulcahy, A., Schwam, D., Lovejoy, S. (2024, February 1). International Prescription Drug Price Comparisons: Estimates Using 2022 Data. RAND Corporation. https://www.rand.org/pubs/research_reports/RRA788-3.html

3. IQVIA Institute for Human Data Science. (2025, April). Understanding the use of medicines in the U.S. 2025: Evolving standards of care, patient access, and spending. https://www.iqvia.com/-/media/iqvia/pdfs/institute-reports/understanding-the-use-of-medicines-in-the-us-2025/iqvia-institute-iqi-us-use-of-medicines-04-25-forweb.pdf

4 Nekui, F., Galbraith, A. A., Briesacher, B. A., Zhang, F., Soumerai, S. B., Ross-Degnan, D., Gurwitz, J. H., & Madden, J. M. (2021). Cost-related Medication Nonadherence and Its Risk Factors Among Medicare Beneficiaries. Medical care, 59(1), 13–21. https://doi.org/10.1097/MLR.0000000000001458