Co-payments and co-insurance fees for drugs have increased an average of 34 percent since implementation of the Patient Protection and Affordable Care Act, according to a study of new health plans from 46 states conducted by HealthPocket.com, a cost-comparison website. Plan enrollees who use brand name drugs and specialty drugs face the greatest burden from the increases in co-payments and co-insurance fees, the analysis found. Enrollees who use medications infrequently, on the contrary, are not likely to notice the cost-sharing increases. Of the four "metal tier" plans, Bronze health insurance plans had the highest increase, 58 percent, while Platinum health insurance plans had the lowest increase, 15 percent. Prior to the Affordable Care Act, nearly one out of five private health insurance plans lacked prescription drug coverage. In comparison, all new health plans in the individual market include a drug benefit.