A growing body of research keeps undermining a key tenet of health economics — the belief that requiring patients to pay more out of their own pockets will make them smarter consumers, forcing the health care system to deliver value.
Driving the news: Even a seemingly modest increase in out-of-pocket costs will cause many patients to stop taking drugs they need, according to a new working paper from Harvard economist Amitabh Chandra.
- Raising Medicare recipients' out-of-pocket costs by just $10 per prescription led to a 23% drop in overall drug consumption, and to a 33% increase in mortality.
- And seniors weren’t simply ditching "low-value" drugs. People at high risk for heart attacks or strokes cut back on statins and blood-pressure medications even more than lower-risk patients.
Between the lines: This research focuses on Medicare's drug benefit, but higher cost-sharing is all the rage throughout the system, and there's little evidence that it has generated "smarter shoppers."
- Patients with high-deductible plans — increasingly common in the employer market — don't shop around for the best deal, which is all but impossible to do in many cases even if you wanted to try.
Go deeper: The "skin in the game" theory of health care hasn't panned out
