We show that serial cost sharing for heterogeneous goods [4], and a large number of other cost sharing mechanisms, have the same strong strategic properties as serial cost sharing for homogenous goods [10], including uniqueness of the Nash equilibrium for all utility profiles and cost functions, dominance solvability, solvability in overwhelmed actions, and robustness to coalitional deviations....

OBJECTIVES To evaluate the effect of consumer cost sharing on use of physician-administered and patient self-administered specialty drugs for rheumatoid arthritis. DESIGN Multivariate statistical analysis of probability and use of physician-administered specialty drugs, patient self-injected specialty drugs, non-biologic disease-modifying anti-rheumatic drugs, and symptom relief drugs. Analys...

PURPOSE To evaluate the effect of patient cost-sharing on oral diabetes medication adherence and glycemic control. DESIGN Retrospective observational study. METHODOLOGY Medical and pharmacy claims from a managed care plan and electronic medical records (EMR) from a large physician organization in Oregon were used to identify a cohort with diabetes. Medication adherence and mean patient cost...

We explore how private drug plans set cost-sharing in the context of Medicare Part D. While publicly-provided drug coverage typically involves uniform cost-sharing across drugs, we document substantial heterogeneity in the cost-sharing for different drugs within privately-provided plans. We also document that private plans systematically set higher consumer cost sharing for drugs or classes ass...

BACKGROUND Little is known about the effect of different forms of patient cost-sharing on the utilization of clinical preventive services or if the effect varies by type of health plan. OBJECTIVES To assess empirically the relationships between the utilization of recommended preventive services and different forms of patient cost-sharing and how the effect is mediated by type of preventive se...

OBJECTIVE To examine the effect of cost-sharing on the use of asthma medications in asthmatic children. According to asthma guidelines, children with asthma may require treatment with multiple medications, including controllers and relievers, to achieve optimal control. Although families may be enrolled in drug benefit plans, impediments to access persist in the form of cost-sharing. DESIGN P...

INTRODUCTION Under the Massachusetts health reform, low income residents (those with incomes below 150 % of the Federal Poverty Level [FPL]) were eligible for Medicaid and health insurance exchange-based plans with minimal cost-sharing and no premiums. Those with slightly higher incomes (150 %-300 % FPL) were eligible for exchange-based plans that required cost-sharing and premium payments. M...

PURPOSE To assess the relationship between patient cost-sharing (e.g., copayments or coinsurance) and adherence and persistence to second-generation (atypical) antipsychotic (SGA) medications. DESIGN AND METHODOLOGY A retrospective, observational study of adults aged 18-64 years with schizophrenia or bipolar disorder (n = 7,910) who initiated SGA medications with employer-sponsored insurance ...

This paper focuses on the design of cost sharing rules to optimize the efficiency of the resulting equilibria in cost sharing games with concave cost functions. Our analysis focuses on two well-studied measures of efficiency, termed the price of anarchy and price of stability, which provide worstcase guarantees on the performance of the (worst or best) equilibria. Our first result characterizes...

Roughgarden and Sundararajan recently introduced an alternative measure of efficiency for cost sharing mechanisms. We study cost sharing methods for combinatorial optimization problems using this novel efficiency measure, with a particular focus on scheduling problems. While we prove a lower bound of Ω(logn) for a very general class of problems, we give a best possible cost sharing method for m...