High Cost-Sharing for Prescription Drugs: Patient Response, Physician Response, and Public Policy

Mariana Carrera, Ph.D. – Assistant Professor of Economics at Case Western Reserve University

Friday September 14, 2012
12:30-1:30 p.m.
Dampeer Room
Kelvin Smith Library
Case Western Reserve University

Dear Colleagues:

Unless you are lucky enough not to need prescriptions, or have someone else pay for them, you may have noticed that over recent years insurance plans have expected patients to pay larger and larger amounts for their medications. They also have used these rules to try to encourage patients to consume some drugs rather than others – with “tiered” benefits.

This cost-sharing is controversial for lots of reasons. One is that it may create inequities as poorer people cannot afford medications. Another is that cost-sharing puts patients in between their doctor and the insurer, which may be encouraging use of different drugs. Cost sharing might still be controversial but would work better if physicians knew what patients would have to pay for drugs they prescribe, and whether they could pay. But what are the odds of that? A great question – and Professor Carrera studies it. She will report on her research about physicians’ response to price constraints on patients – and discuss what that suggests for policies about cost-sharing for drugs.

All best regards,
Joe White
Luxenberg Family Professor of Public Policy and Director, Center for Policy Studies

About Our Guest…

The research interests of Mariana P. Carrera, Ph.D., lie in the fields of health economics and behavioral economics. Her recent work is focused on drug prescribing and adherence decisions. She investigates how physicians respond to patient copayments and patient price sensitivity when choosing which drug to prescribe, and how the complex variation in copayments across insurance plans can obstruct their response.

In another ongoing project, Dr. Carrera is investigating what drives consumer preferences for brand-name over-the-counter drugs. Understanding the factors of rigid brand attachment will inform current debates about direct-to-consumer drug advertising and consumer engagement in healthcare decisions. Other current projects center on commitment devices for exercise and for healthy eating.

Dr. Carrera obtained her Ph.D. in Economics at the University of California-Berkeley.

Where We Meet

The Friday Public Affairs Lunch convenes each Friday when classes are in session, from 12:30 p.m. to 1:30 p.m. We usually meet in the Dampeer Room of Kelvin Smith Library. The Dampeer Room is on the second floor of the library. If you get off the elevators, turn right, pass the first bank of tables, and turn right again. Occasionally we need to use a different room; that will always be announced in the weekly e-mails.

Parking Possibilities

The most convenient parking is the lot underneath Severance Hall. We regret that it is not free. From that lot there is an elevator up to street level (labeled as for the Thwing Center); it is less than 50 yards from that exit to the library entrance. You can get from the Severance garage to the library without going outside. Near the entry gates – just to the right if you were driving out – there is a door into a corridor. Walk down the corridor and there will be another door. Beyond that door you’ll find the entrance to an elevator which goes up to an entrance right inside the doors to Kelvin Smith Library.

Friday Lunch Upcoming Topics and Speakers:

September 14: High Cost-Sharing for Prescription Drugs: Patient Response, Physician Response, and Public Policy. With Mariana Carrera, Assistant Professor of Economics

September 21: The Future of University Libraries. With Arnold Hirshon, Associate Provost and University Librarian

September 28: The European Economy and EU Politics. With Elliot Posner, Associate Professor of Political Science***Special Location: Mather House 100***

October 5: Presidents and the Media. With Jeffrey E. Cohen Ph.D., Professor and Chair, Department of Political Science, Fordham University

October 12: The Future of Primary Care. With George Kikano MD, Chair, Department of Family Medicine.

October 19: Biblical Rhetoric in the 2012 Elections. With Timothy K. Beal, Florence Harkness Professor of Religion.

October 26: Special Event in Memory of Alec Lamis – “Insecure Majorities: Congress and the Permanent Campaign.” With Frances E. Lee, Professor of Government and Politics, University of Maryland ***Special Location: Wolstein Medical Research Building auditorium, first floor, 2103 Cornell Road. Lunch and Mama Jo’s pies provided.***

November 2: Political Science Department Pre-Election Forecasts. With Justin Buchler, Associate Professor of Political Science, and colleagues.

November 9: What Just Happened? Open discussion about the election results, with Joe White, Chair, Department of Political Science.

November 16: Learning from Mad Cows. With Dr. Pierluigi Gambetti, Professor and Director, Division of Neuropathology and Director, National Prion Disease Pathology Surveillance Center.

November 23: No Session – Thanksgiving Break

November 30: The Medium is the Message: What Happens When Universities Digitize Course Evaluations. With Timothy J. Fogarty, Professor of Accountancy.

December 7: The “Chicago Boys” Without Pinochet: Privatization and Protest in Chile. With Diane Haughney, Ph.D.