ArticleThe quarterly journal of economics2024
The Health Costs of Cost Sharing.
Article in The quarterly journal of economics, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 41 papers.
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.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
41 citing papers in PubMed.
- Delivery Timing, Out-Of-Pocket Maternity Costs, and Postpartum Care Utilization: An Instrumental Variable Analysis Among Commercially Insured Women.Health services research · 2026Article
- Changes in Medication Use After Medicare Part D Annual Out-of-Pocket Spending Caps.JAMA health forum · 2026Article
- Trends in prescription drug coverage restrictions in Medicare, Medicaid, and commercial insurance plans, 2011-2019.Health affairs scholar · 2026Article
- Understanding financial toxicity in cancer care through a social-ecological lens.Current opinion in oncology · 2026Review
- Use and Out-of-Pocket Costs of Antenatal Fetal Surveillance for Patients With Chronic Conditions.O&G open · 2026Article
- The Business Case for Family Caregiver Skills Training: Results From a Multisite Trial in the Veterans Health Care System.Journal of the American Medical Directors Association · 2026Article
- Changes in Medication Use During Medicaid Continuous Enrollment and Unwinding.JAMA health forum · 2026Article
- The Association of Outpatient Cost-Sharing Policy with Health and Economic Outcomes for Rural Children in China: A Cross-Sectional Study.Healthcare (Basel, Switzerland) · 2025Article
- Insurance Expansion During Pregnancy.Health economics · 2025Article
- Changes in Medicare Part D Plan Designs After the Inflation Reduction Act.JAMA internal medicine · 2025Article
- Loss of Subsidized Drug Coverage and Mortality among Medicare Beneficiaries.The New England journal of medicine · 2025Article
- Calcimimetic Prescriptions in Fee-for-Service Medicare Beneficiaries Undergoing Dialysis.JAMA health forum · 2025Article
- High-Deductible Health Plans and Receipt of Guideline-Concordant Care for Adults With Chronic Illness.JAMA network open · 2025Article
- Challenges Related to Out-of-Pocket Costs in Heart Failure Management.Circulation. Heart failure · 2025Review
- Racial and Ethnic Differences in Out-of-Pocket Spending for Maternity Care.JAMA health forum · 2025Article
- Forgoing Healthcare and Insurance Premiums Trends: A 15-Year Population-Based Study in Geneva, Switzerland.International journal of public health · 2025Article
- Macro- and micro-influencers of antimicrobial costs…What do stewardship programs need to know?Antimicrobial stewardship & healthcare epidemiology : ASHE · 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
- Estimated Savings Under the Medicare High-Value Drug List Model.JAMA internal medicine · 2024Article
- The Health Costs of Cost Sharing.The quarterly journal of economics · 2024Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
3 authors.
Funding
Abstract
What happens when patients suddenly stop their medications? We study the health consequences of drug interruptions caused by large, abrupt, and arbitrary changes in price. Medicare's prescription drug benefit as-if-randomly assigns 65-year-olds a drug budget as a function of their birth month, beyond which out-of-pocket costs suddenly increase. Those facing smaller budgets consume fewer drugs and die more: mortality increases 0.0164 percentage points per month (13.9%) for each $100 per month budget decrease (24.4%). This estimate is robust to a range of falsification checks and lies in the 97.8th percentile of 544 placebo estimates from similar populations that lack the same idiosyncratic budget policy. Several facts help make sense of this large effect. First, patients stop taking drugs that are both high value and suspected to cause life-threatening withdrawal syndromes when stopped. Second, using machine learning, we identify patients at the highest risk of drug-preventable adverse events. Contrary to the predictions of standard economic models, high-risk patients (e.g., those most likely to have a heart attack) cut back more than low-risk patients on exactly those drugs that would benefit them the most (e.g., statins). Finally, patients appear unaware of these risks. In a survey of 65-year-olds, only one-third believe that stopping their drugs for up to a month could have any serious consequences. We conclude that far from curbing waste, cost sharing is itself highly inefficient, resulting in missed opportunities to buy health at very low cost ($11,321 per life-year).
Identifiers
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.