Author Affiliations: Program of Child Health Evaluative Sciences, The Hospital for Sick Children, and Institute of Health Policy, Management, and Evaluation, University of Toronto, Toronto, Ontario, Canada.
To adapt to increasing economic pressures, large insurers and drug benefit programs have turned to medication cost sharing, ie, sharing the cost of medications with patients through co-payments, coinsurance, and deductibles, to reduce overall plan costs. More than 2 decades ago, the Rand Health Insurance Experiment showed that patients reduce consumption of necessary health services when faced with cost sharing.1 The effect of medication cost sharing on health resource use has since been studied in adult chronic diseases2- 4 but has received little attention in children. Studying the effects of medication cost sharing on child health is complex because parents act as gatekeepers, both for access to health care services and with regard to how disease management plans and drug regimens are implemented. Moreover, a parent's gatekeeper role changes as a child ages.
Ungar WJ. Medication Cost Sharing and Health Outcomes in Children With Asthma. JAMA. 2012;307(12):1316-1318. doi:10.1001/jama.2012.365