| 来源类型 | Working Paper |
| 规范类型 | 报告 |
| DOI | 10.3386/w28439 |
| 来源ID | Working Paper 28439 |
| The Health Costs of Cost-Sharing | |
| Amitabh Chandra; Evan Flack; Ziad Obermeyer | |
| 发表日期 | 2021-02-08 |
| 出版年 | 2021 |
| 语种 | 英语 |
| 摘要 | We use the design of Medicare’s prescription drug benefit program to demonstrate three facts about the health consequences of cost-sharing. First, we show that an as-if-random increase of 33.6% in out-of-pocket price (11.0 percentage points (p.p.) change in coinsurance, or $10.40 per drug) causes a 22.6% drop in total drug consumption ($61.20), and a 32.7% increase in monthly mortality (0.048 p.p.). Second, we trace this mortality effect to cutbacks in life-saving medicines like statins and antihypertensives, for which clinical trials show large mortality benefits. We find no indication that these reductions in demand affect only ‘low-value’ drugs; on the contrary, those at the highest risk of heart attack and stroke, who would benefit the most from statins and antihypertensives, cut back more on these drugs than lower risk patients. Similar patterns exist for other drug–disease pairs, and irrespective of socioeconomic circumstance. Finally, we document that when faced with complex, high-dimensional choice problems, patients respond in simple, perverse ways. Specifically, price increases cause 18.0% more patients (2.8 p.p.) to fill no drugs, regardless of how many drugs they had been on previously, or their health risks. This decision mechanically results in larger absolute reductions in utilization for those on many drugs. We conclude that cost-sharing schemes should be evaluated based on their overall impact on welfare, which can be very different from the price elasticity of demand. |
| 主题 | Health, Education, and Welfare ; Health |
| URL | https://www.nber.org/papers/w28439 |
| 来源智库 | National Bureau of Economic Research (United States) |
| 引用统计 | |
| 资源类型 | 智库出版物 |
| 条目标识符 | http://119.78.100.153/handle/2XGU8XDN/586112 |
| 推荐引用方式 GB/T 7714 | Amitabh Chandra,Evan Flack,Ziad Obermeyer. The Health Costs of Cost-Sharing. 2021. |
| 条目包含的文件 | ||||||
| 文件名称/大小 | 资源类型 | 版本类型 | 开放类型 | 使用许可 | ||
| w28439.pdf（1083KB） | 智库出版物 | 限制开放 | CC BY-NC-SA | 浏览 | ||
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