During a heated exchange over health reform during the December Democratic presidential primary debate, Sen. Elizabeth Warren turned to the topic of high prescription drug prices.

"Last year, 36 million Americans didn’t have a prescription filled because they couldn’t afford it," the Massachusetts senator said.

Drug prices are a persistent hot-button issue, and one of the health issues voters say they most want Washington to take on. So we decided to take a closer look.

We contacted the Warren campaign, which directed us to a February survey from the Commonwealth Fund, a foundation headquartered in New York.

The data

The Commonwealth data supports Warren’s point; in fact, it’s a slightly larger number than she said on the debate stage.

In 2018, the researchers estimate, 37 million non-elderly adults went without filling a prescription because they could not afford it. That’s almost 1 in 5 of the U.S. population.

Having coverage, the researchers note, doesn’t guarantee you’ll afford medication. The survey makes a point of noting the 87 million non-elderly adults are uninsured, experienced a gap in coverage or "underinsured" — which means they had coverage the entire year, but still faced out-of-pocket costs (excluding premiums) that imposed a substantial financial burden.

That’s another point Warren — and other candidates — repeated during the debate’s health care portion.

"Those are people with health insurance, as well," Warren added. "People who can't do the copays, people without can't do the deductibles."

The Commonwealth paper suggests much of this "underinsurance" issue comes from deterioration of health plans Americans get through work, which is the way most non-elderly Americans get coverage.

Commonwealth isn’t the only organization to look at this question of prescription drug affordability. A November poll from West Health and Gallup surveyed more than 1,000 adults, asking them if, in the past 12 months, they had not had enough money to afford a doctor-recommended medication.

About 23 percent of respondents reported such an issue — a figure Gallup extrapolated to suggest 58 million Americans experiencing what it called “medication insecurity.”

Meanwhile, a February poll from the Kaiser Family Foundation found that of adults taking prescription drugs, about one in four reported some difficulty in affording that medication. (Kaiser Health News is an editorially independent program of the foundation.)

The findings drive home a crucial point: broadly, Warren’s number matches what the data shows. If anything, it could be even worse than she suggested.

Our ruling

Warren said that last year, 36 million Americans forewent a prescription because of the cost barrier.

The data supports her claim. And other research further paints a picture of widespread affordability problems.

We rate this claim True.