Prioritizing Benefit? How Low-Income Patients Respond to Prescription Cost Sharing
中文摘要
本文衡量费用分担如何影响年长的低收入患者, 利用那些失去与医疗补助 (Medicaid) 挂钩项目资格者获得处方药补贴资格上的断点。补贴丧失导致药品价格上涨, 使处方支出减少 40%, 这源于处方配药数量下降 16%。患者会节省购买价格较高的药品, 而不论其健康收益如何。例如, 患者将胰岛素购买量减少 35%。没有证据表明费用分担促使患者从品牌药转向仿制药。这一行为表明, 费用分担降低了处方的可及性, 却未提升成本效益。
Abstract
This paper measures how cost sharing impacts older low-income patients, exploiting a discontinuity in eligibility for a prescription drug subsidy for those who lose access to the Medicaid-linked program. Higher drug prices resulting from subsidy loss lead to a 40 percent reduction in prescription expenditures, driven by a 16 percent quantity reduction of prescriptions filled. Patients economize on purchases of higher-priced drugs, irrespective of their health benefits. For example, patients reduce insulin purchases by 35 percent. There is no evidence that cost sharing prompts switching from branded drugs to generics. This behavior suggests that cost sharing reduces prescription accessibility without enhancing cost-effectiveness.