The trend: Consumers weigh multiple factors before filling a prescription, some of which may lead to medication abandonment, according to M3 MI’s MARS 2026 Consumer Health Study, which surveyed more than 20,000 US adults ages 18 and older.

When deciding whether to fill a prescription, consumers consider:

• Side effects/safety risks (40%)
• If the medication is actually needed for health improvement (36%)
• Cost (35%)
• If a lifestyle modification could be a viable alternative (28%)
• Whether a drug is among the top brands in its category (18%)
• If they’ve heard stories from patients who have taken the drug (14%)

Those drivers look similar to their top reasons for not filling/refilling prescriptions, which include:

• Concerns over side effects (23%)
• Lack of insurance coverage or approval (20%)
• Saving money (18%)
• Lack of certainty thatthe drug was working (15%)
• Preference to treat with alternatives (e.g., over-the-counter (OTC) medication, diet, exercise)

Why it matters: The survey data shows that getting a doctor to prescribe a medication doesn't guarantee patients will fill it, take it, and stay on it. Yet, medication adherence is closely tied to treatment effectiveness and overall patient health.

There are more than 100,000 preventable deaths and $100 billion in avoidable medical costs annually because people are not taking medicines as prescribed. While the medical benchmark for medication adherence is having 80% of people have access to their medications for at least 80% of days, per the CDC, 50% of patients do not take their medications as prescribed. For pharma manufacturers, maximizing a medicine’s value depends on patients taking it as prescribed to realize its intended clinical benefit.

Implications for pharma brands and marketers: Winning the prescription is only half the battle. Pharma brands need to close the confidence gap between prescription and adherence by reassuring patients that their treatment is necessary, manageable, affordable, and working as expected.

Marketers should prioritize the post-prescription window with education that reinforces the top factors contributing to unfulfilled prescriptions. They’ll need to explain why their medication is prescribed over OTC alternatives, what it is intended to accomplish, when patients can expect results, and what to ask their physician or pharmacist if they have concerns.

Affordability support is another opportunity. Many patients may abandon or swap treatments without knowing savings exist. For example, most consumers don’t use manufacturer coupons that could lower costs, potentially because they rely on insurers for pricing information rather than pharma-directed resources. Marketers can address this by making savings resources more visible at key decision points, like via a doctor when their medication is prescribed, or via a pharmacist when a consumer gets to the counter.

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