ArticleJournal of general internal medicine2008
Effects of increased patient cost sharing on socioeconomic disparities in health care.
Article in Journal of general internal medicine, 2008. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT02621476 (Encouraging Mail Order Pharmacy Use to Improve Outcomes and Reduce Disparities), which is not on this map. Cited by 63 papers, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Encouraging Mail Order Pharmacy Use to Improve Outcomes and Reduce Disparities
Who cites it
63 citing papers in PubMed, 1 synthesis or guideline pooled it, 153 citations in OpenAlex.
- Association of Social Determinants of Health with Utilization of SGLT2 Inhibitors and GLP1 Receptor Agonists: A Systematic Review and Meta-Analysis.Journal of general internal medicine · 2026Pooled it
- A Randomized Encouragement Trial to Increase Mail Order Pharmacy Use and Medication Adherence in Patients with Diabetes.Journal of general internal medicine · 2021Trial
- Assigned But Not Anchored: A Study of Primary Care Provider Utilization Among Covered California Enrollees.Journal of general internal medicine · 2026Article
- Insulin Costs and Use by Medicare Beneficiaries After the Inflation Reduction Act Out-of-Pocket Cap.JAMA · 2026Article
- Association Between Copayments and Attendance in Cardiac Rehabilitation: A Nationwide Analysis From the AACVPR Registry.Journal of the American Heart Association · 2026Article
- Review
- No Cost Sharing for Public Assistance Recipients and Health Service Usage in Japan.JAMA health forum · 2025Article
- Loss of Subsidized Drug Coverage and Mortality among Medicare Beneficiaries.The New England journal of medicine · 2025Article
- Economic Evidence on Cost Sharing and Alternative Insurance Designs to Address Moral and Behavioral Hazards in High-Income Health Care Systems: A Systematic Review.Journal of market access & health policy · 2024Review
- Clustering affordable care act qualified health plans to understand how and where insurance facilitates or impedes access to HIV prevention.AIDS research and therapy · 2024Article
- Impact of NHI copayment adjustments on healthcare seeking behavior: the mediating role of health facility identification.BMC health services research · 2024Article
- The Cost to Breathe: Eliminating Cost Sharing Associated with Lung Cancer Screening.Annals of the American Thoracic Society · 2024Article
- Assessment of racial and ethnic inequities in copay card utilization and enrollment in copay adjustment programs.Journal of managed care & specialty pharmacy · 2023Article
- Research on the influence of patient cost-sharing on medical expenses and health outcomes: Taking patients with heart failure as an example.Frontiers in public health · 2023Article
- Association Between Copayment Amount and Filling of Medications for Angiotensin Receptor Neprilysin Inhibitors in Patients With Heart Failure.Journal of the American Heart Association · 2022Article
- Consequences of forgoing prescription drug subsidies among low-income Medicare beneficiaries with diabetes.Health services research · 2022Article
- The effects of patient cost-sharing on health expenditure and health among older people: Heterogeneity across income groups.The European journal of health economics : HEPAC : health economics in prevention and care · 2022Article
- Strategies to Reduce Low-Value Cardiovascular Care: A Scientific Statement From the American Heart Association.Circulation. Cardiovascular quality and outcomes · 2022Review
- Multimorbidity and out-of-pocket expenditure on medicine in Europe: Longitudinal analysis of 13 European countries between 2013 and 2015.Frontiers in public health · 2022Article
- Article
3 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
6 authors at 4 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundIncreasing patient cost sharing is a commonly employed mechanism to contain health care expenditures.
objectiveTo explore whether the impact of increases in prescription drug copayments differs between high- and low-income areas.
designUsing a database of 6 million enrollees with employer-sponsored health insurance, econometric models were used to examine the relationship between changes in drug copayments and adherence with medications for the treatment of diabetes mellitus (DM) and congestive heart failure (CHF). SUBJECTS: Individuals 18 years of age and older meeting prespecified diagnostic criteria for DM or CHF were included. MEASUREMENTS: Median household income in the patient's ZIP code of residence from the 2000 Census was used as the measure of income. Adherence was measured by medication possession ratio: the proportion of days on which a patient had a medication available.
resultsPatients in low-income areas were more sensitive to copayment changes than patients in high- or middle-income areas. The relationship between income and price sensitivity was particularly strong for CHF patients. Above the lowest income category, price responsiveness to copayment rates was not consistently related to income.
conclusionsThe relationship between medication adherence and income may account for a portion of the observed disparities in health across socioeconomic groups. Rising copayments may worsen disparities and adversely affect health, particularly among patients living in low-income areas.
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What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.