Pharmacy cost in cancer.

2019 ◽  
Vol 37 (15_suppl) ◽  
pp. e18358-e18358
Author(s):  
Surbhi Shah ◽  
Nathan Rubin
Keyword(s):  
Health Care ◽  
Drug Cost ◽  
Economic Burden ◽  
Cancer Care ◽  
Cost Of Care ◽  
Pharmacy Cost ◽  
Health Care Spending ◽  
Total Cost ◽  
The Cost ◽  
Active Cancer

e18358 Background: Health care spending in US is highest in the developed world and contributes to up to 1/5 of the GDP. The price escalation is steep and contribution from cancer care is soaring. The cost of medications is deemed to be the leading cause of increased health care spending. In this era of precision medicine, with more effective and better tolerated drugs, patients are using them for longer periods of time, adding to the ever mounting health care spending. Methods: We used a large claims based data set US database MarketScan to explore the economic burden of drug cost in cancer care. Between January 1, 2013 and September 30, 2015 we identified 195,290 enrollees with active cancer. We analyzed the economic burden of medications for overall cancer care by exploring the total cost of care and the pharmacy expenditure by various classes of drugs for these patients. The perspective was that of the health care system as the costs included payments by the insurer and the patient. Results: There were 195,290 active cancer patients in this analysis. Mean age was 61 years, 55% were females. Breast cancer was the most common diagnosis. Mean total cost of care and total drug cost per patient over the study period was $141,415 and $13,579, respectively. The total pharmacy expenditure across all study patients was ~2.5B. Antineoplastic drugs make up the largest portion of the total pharmacy expenditure at 39%. Cost contribution based on drug categories were anti-infective (6%), cardiovascular (6%), central nervous system (including opiates, anti-nausea medications and antidepressants) (7%), blood formulations (including anticoagulants) (8%), hormones (8%) and gastrointestinal drugs (4%) respectively. Conclusions: Based on the real world information from a large insurance claims database, this study quantifies the contribution of various drug classes to the cost of cancer care. Antineoplastic contribute to > 1/3rd of the total pharmacy spending. With increasing trend for immunotherapy and combination therapy drug costs are bound to go up even more steeply. Unless drug prices are regulated, we are looking towards an unsustainable level of growth in the health care spending in cancer care.

Provider-patient communication about cost of care: Results from a national patient education program.

2013 ◽  
Vol 31 (15_suppl) ◽  
pp. 9578-9578 ◽  
Author(s):  
Ivy A. Ahmed ◽  
Allison Harvey ◽  
Marni Amsellem ◽  
Thomas J. Smith
Keyword(s):  
Health Care ◽  
Health Care Professionals ◽  
Cancer Care ◽  
Health Care Team ◽  
Cost Of Care ◽  
Care Team ◽  
Cancer Support ◽  
Support Organizations ◽  
National Patient ◽  
The Cost

9578 Background: A 2010 NIH study indicates direct cancer care expenditures will reach $158 billion in the U.S. by 2020, impacting millions of Americans. The cost of insurance for a family of 4 has increased from $6000 (2000) to over $16,000 (2011). Medical debt is a significant cause of personal bankruptcy, even if insured. The financial realities posed by costs associated with cancer care greatly complicate a cancer diagnosis. The most recent American College of Physicians Ethics Manual recommends all parties must interact honestly, openly, and fairly. (Snyder L, et al. Ann Int Med 2012, p86) This analysis explores the occurrence and value of patient-provider communication surrounding costs associated with care in a national survey of those affected by cancer. Methods: From 2011-12, 505 individuals attending Frankly Speaking About Cancer: Coping with the Cost of Care workshops completed a survey assessing experiences about the costs of cancer care. This is a Cancer Support Community national evidence-based educational program. All attendees (n=708) were eligible to complete survey. Results: Most attendees (71.3%) responded. The majority (62.4%) were people with cancer/survivors; the remainder included spouses/partners, family members, and 8.7% were health care professionals. Most (80.8%) were Caucasian, and averaged 57.2 years. Of those with cancer, 89.9% were insured at diagnosis. 59.4% reported no one on their health care team initiated a discussion about the financial aspects of their care. Included in this figure, 22.7% actively sought information from health care team, and 36.7% received no information about cost. When topic was initiated, it was by social workers (16.2%), physicians (12.3%), nurses (6.3%) or financial specialists (8.2%). When information was provided, 72.1% found it somewhat or very useful. Also, regardless of provider discussion, respondents independently sought resources for managing costs, such as other patients (44.2%), the Internet (41.5%), and patient support organizations (38.1%). Conclusions: Patients want financial information but do not receive it. These data highlight the need and value of providers initiating a dialogue about the cost of cancer care with patients.

American Society of Clinical Oncology Guidance Statement: The Cost of Cancer Care

2009 ◽  
Vol 27 (23) ◽  
pp. 3868-3874 ◽  
Author(s):  
Neal J. Meropol ◽  
Deborah Schrag ◽  
Thomas J. Smith ◽  
Therese M. Mulvey ◽  
Robert M. Langdon ◽  
...  
Keyword(s):  
United States ◽  
Health Care ◽  
Clinical Oncology ◽  
Cancer Care ◽  
Cost Effective ◽  
The United States ◽  
Cost Of Care ◽  
High Quality ◽  
American Society ◽  
The Cost

Advances in early detection, prevention, and treatment have resulted in consistently falling cancer death rates in the United States. In parallel with these advances have come significant increases in the cost of cancer care. It is well established that the cost of health care (including cancer care) in the United States is growing more rapidly than the overall economy. In part, this is a result of the prices and rapid uptake of new agents and other technologies, including advances in imaging and therapeutic radiology. Conventional understanding suggests that high prices may reflect the costs and risks associated with the development, production, and marketing of new drugs and technologies, many of which are valued highly by physicians, patients, and payers. The increasing cost of cancer care impacts many stakeholders who play a role in a complex health care system. Our patients are the most vulnerable because they often experience uneven insurance coverage, leading to financial strain or even ruin. Other key groups include pharmaceutical manufacturers that pass along research, development, and marketing costs to the consumer; providers of cancer care who dispense increasingly expensive drugs and technologies; and the insurance industry, which ultimately passes costs to consumers. Increasingly, the economic burden of health care in general, and high-quality cancer care in particular, will be less and less affordable for an increasing number of Americans unless steps are taken to curb current trends. The American Society of Clinical Oncology (ASCO) is committed to improving cancer prevention, diagnosis, and treatment and eliminating disparities in cancer care through support of evidence-based and cost-effective practices. To address this goal, ASCO established a Cost of Care Task Force, which has developed this Guidance Statement on the Cost of Cancer Care. This Guidance Statement provides a concise overview of the economic issues facing stakeholders in the cancer community. It also recommends that the following steps be taken to address immediate needs: recognition that patient-physician discussions regarding the cost of care are an important component of high-quality care; the design of educational and support tools for oncology providers to promote effective communication about costs with patients; and the development of resources to help educate patients about the high cost of cancer care to help guide their decision making regarding treatment options. Looking to the future, this Guidance Statement also recommends that ASCO develop policy positions to address the underlying factors contributing to the increased cost of cancer care. Doing so will require a clear understanding of the factors that drive these costs, as well as potential modifications to the current cancer care system to ensure that all Americans have access to high-quality, cost-effective care.

Reshaping the Health-Care State

1994 ◽  
Vol 29 (1) ◽  
pp. 48-63 ◽  
Author(s):  
Michael Moran
Keyword(s):  
Health Care ◽  
Gross National Product ◽  
Cost Of Care ◽  
The State ◽  
National Product ◽  
Health Care Spending ◽  
Power Structures ◽  
Capitalist World ◽  
The Cost

Health Care Has Been Called ‘The World's Most successful industry’. That success is long-standing. In every nation for which we have reliable long-term evidence the proportion of Gross National Product devoted to health care is much higher than was the cast a generation ago. The state has been central to that expansion. In all advanced industrial nations it regulates health care industries; in many it pays most of the cost of care; and in some it directly employs those who do the caring. In the 1980s, however, most countries tried to slow down the growth of health care spending, or even to cut it absolutely. The ‘health care state’ is as a consequence being reshaped across the advanced capitalist world: its power structures are changing; the conditions under which it funds and delivers services are being altered; and its relations with the ‘consumers’ of care are being transformed.

Comparison of 12-Month Treatment Costs for Patients with Advanced Phase Chronic Myeloid Leukemia (CML) in China: Imatinib (IM) vs. Chemotherapy (Chemo) Plus Interferon-(IFN) in Accelerated Phase (AP) CML and IM vs. Chemo in Blast Crisis (BC) CML.

Blood ◽  
2007 ◽  
Vol 110 (11) ◽  
pp. 5169-5169
Author(s):  
Zi Chen ◽  
Chun Wang ◽  
Weiwei Feng
Keyword(s):  
Health Care ◽  
Adverse Events ◽  
Supportive Care ◽  
Drug Cost ◽  
Office Visits ◽  
Cost Of Treatment ◽  
Total Cost ◽  
Advanced Phase ◽  
The Cost ◽  
Care Costs

Abstract Background: IM, an oral molecular targeted therapy, has demonstrated impressive efficacy in treating advanced CML. In China, IM has been approved to treat all phases of CML. However, it was not considered for reimbursement at national level. Chemos such as Homoharringtonine combined with cytarabine (HA) or Theprucine in combination with cytarabine (TA) have been used and reimbursed to treat advanced CML patients. The objective of this study was to conduct a total cost of treatment analysis comparing IM with chemo (HA or TA) in combination with IFN in AP and IM vs. chemo in BC CML in China. Methods: Total cost of treatment contained drug cost, office visits, lab tests, hospitalizations, and cost of managing adverse events (AEs) and supportive care. The cost of managing AEs included the use of G-CSF, anti-infective medications, and blood transfusions. Treatment protocols for AP and BC CML from tier 3 hospitals in China were used to estimate the costs associated with treatment. Drug prices were based on the listed retail price in China. Dosages for IM and IFN were based on the approved product labels in China. Results: AP patients received on average 3 courses of chemo in the hospital during a year and were treated with interferon-while off the chemo. BC patients received one course chemo every two months. As shown in the table, the 12-month cost of treatment for an AP patient treated with IM was RMB119,850 vs. RMB153,900 with chemo plus IFN. The corresponding numbers for a BC patient were RMB133,450 with IM vs. RMB18,5400 with chemo. Hospitalizations and costs of managing adverse events and supportive care were the key drivers of the savings for IM. The health care costs savings related to taking IM outweigh the drug cost difference between IM and chemo plus IFN in AP or IM and chemo in BC. Conclusion: AP CML patients treated with IM incurred over RMB30,000 less health care costs in 1-year than those treated with chemo plus IFN. The savings were even more in BC: the 1-year cost of treatment with IM was over RMB50,000 lower than that with chemo. The cost of chemo used in this analysis was based on the 1st line chemo used in China. If patients failed the 1st line chemo, more expensive 2nd line chemos were usually used. Therefore, the total cost of treatment with chemo in advanced CML could be even more if 2nd line chemos were considered in this analysis. Providing advanced CML patients access to IM will not only improve clinical outcomes but also reduce the overall economic burden to the Chinese health care system. Total 12-month Cost of Treatment for Advanced Phase CML Patients (unit: RMB) AP BC Imatinib Chemo+IFN Imatinib Chemo *Other = Chemo + IFN in AP; Other = Chemo in BC Drug cost 114,750 75,000 114,750 42,000 Office visits 600 8,100 600 9,000 Lab tests 600 3,600 600 included in above office visits Hospitalizations 1,400 18,000 6,000 36,000 Cost of managing AEs and supportive care 2,500 49,200 11,500 98,400 Total cost of treatment 119,850 153,900 133,450 185,400 Difference in total cost of treatment (Imatinib - Other*) − 34,050 − 51,950

scholarly journals Economic Burden of Venous Thromboembolism in Cancer Patients — a Comparative Analysis between Matched Patients with Cancer with and without a Diagnosis of Venous Thromboembolism

Blood ◽  
2018 ◽  
Vol 132 (Supplement 1) ◽  
pp. 366-366 ◽  
Author(s):  
Surbhi Shah ◽  
Nathan Rubin ◽  
Alok A. Khorana
Keyword(s):  
Cancer Patients ◽  
Economic Burden ◽  
Drug Costs ◽  
Cost Difference ◽  
Total Cost ◽  
Patients With Cancer ◽  
Median Total Cost ◽  
Number Of Visits ◽  
The Cost ◽  
Active Cancer

Abstract Background:Venous thromboembolism (VTE) is a major health problem occurring at a rate of 1/1000 adults in general population. Cancer patients have a much higher risk of VTE with an annual rate of 24.6/1000 patients and this contributes to significant morbidity and mortality in this patient population. The body of evidence related to the economic burden for VTE in cancer patients is limited to small institutional studies. With increasing burden of cost for cancer care there is a significant push for cost containment measures, physicians taking care of these patients should be more aware of the economic outcomes of their patient cares. Methods: We used a large claims based data set US database MarketScan (Truven Health Analytics) to explore the economic burden of VTE in cancer patients. Between January 1, 2013 and September 30, 2015 we identified 614,577 patients with cancer of these 195,290 were deemed to have active cancer out of which 6,569 had a VTE code in their medical claims. This study was conducted to assess the economic burden of VTE in cancer patients in comparison their non-VTE peers with similar cancer type. All-cause costs over 3-year period were used and included the costs of all services. These were further explored to compare the total cost of care, cost based on the site of utilization of care and pharmacy cost between the patients with VTE with their matched peers. VTE-related costs were identified with a primary or secondary diagnosis of DVT or PE, and were evaluated for the entire follow-up period, starting from the initiation of the anticoagulant therapy until end of eligibility or end of data, whichever was earlier. Continuous factors were summarized by the median. Wilcoxon signed-rank tests were used to test for differences in the distribution between the VTE and non-VTE groups for cost and number of visits. Overall costs as well as total cost per day/visit were compared between groups. The costs were also evaluated by site of utilization (Emergency room vs inpatient vs outpatient) and by cancer subtype. Results: Among active cancer enrollees, there were 6,569 (3.4%) enrollees with VTE and 188,721 (96.6%) without. Average age was around 60 years in both groups. There were approximately 50 % females in each group and breast cancer was the most common type of cancer in the non-VTE group while gastrointestinal cancers were more common in the VTE group. Incidence of comorbid conditions like diabetes, hypertension and chronic kidney disease was similar in both cohorts but chronic liver disease was found more often in the VTE cohort. The median total cost over the study period for the VTE group ($136,976) was 2.0 times that of the non-VTE group ($67,115). This pattern holds for the inpatient, emergency, and outpatient costs. Total median drug costs were about 4 times that of the VTE group ($10,457) than the non-VTE group ($2,621). The difference the cost between groups for these measures were all highly statistically significant (<0.001). However, the VTE group also had 1.7 times the median number of days/visits than the non-VTE group (p < 0.001 for all categories). After adjusting for the number of days, the median total cost per visit was still statistically significant (p<0.001); however the cost difference is much smaller ($1,132 in VTE vs. $984 in non-VTE,). The overall total cost in the VTE groups ranges from 1.3 (pancreatic) to 3.4 (other cancers) times that of the non-VTE patients for the various cancer types, all were statistically significant (p<0.001). After adjusting for the number of visits, the relative cost difference decreased for all cancer groups it ranges from 0.97 (gynecological) to 1.5 (other cancer) times that of the non-VTE patients for the various cancer groups. Lung, breast, gastrointestinal, and other types were statistically significant (p < 0.01). Discussion: Based on the real world information from a large insurance claims database, this study quantifies the incremental health care cost burden associated with VTE in cancer patients. It is clear from this study the patients with cancer and VTE seek medical care more frequently than their non-VTE counterparts leading to higher healthcare costs in all settings. It was also interesting to note that when only the drug costs were taken into consideration, enrollees with VTE had up to 4 times higher drug costs, not all of which was attributable to the anticoagulant cost. Disclosures Khorana: Bayer: Consultancy; Sanofi: Consultancy; Pfizer: Consultancy; Janssen: Consultancy.

scholarly journals Cost effective analysis of tab. nitrofurantoin vs. inj. ceftriaxone as an empirical therapy in patients of urinary tract infection at a tertiary health care centre

2018 ◽  
Vol 7 (12) ◽  
pp. 2393
Author(s):  
Nikhil S. Yadav ◽  
Swanand S. Pathak
Keyword(s):  
Health Care ◽  
Urinary Tract Infection ◽  
Urinary Tract ◽  
Tract Infection ◽  
Empirical Therapy ◽  
Cost Effective ◽  
Cost Of Care ◽  
Total Cost ◽  
Tract Infections ◽  
The Cost

Background: Urinary tract infections (UTI) are commonly seen in adults, Urinary tract infection and asymptomatic bacteriuria in adults are a significant health care burden. In a developing country it is necessary to minimize the cost of therapy while giving maximum health benefits to the patient. Appropriate antimicrobial selection is clearly important, as treatment failures will increase the cost of care and result in additional morbidity for patients. Empirical treatment of urinary tract infection is common at tertiary health care center, authors conducted a pharmacoeconomic study to evaluate cost effectiveness of the empirical treatment.Methods: Patients with similar symptoms suffering from UTI were divided into 5 groups with 10 patients in each group. Each group was subdivided into two subgroups with subgroup A having five patients receiving tab nitrofurantoin and subgroup B having 5 patients receiving inj ceftriaxone. Out of the total cost of therapy, percentage of cost attributed to tab nitrofurantoin was compared with inj ceftriaxone. Most cost-effective antibiotic was analysed. Average number of admission days for groups of UTI patients receiving tab nitrofurantoin and inj ceftriaxone were calculated and compared. Group of UTI patients receiving antibiotic with least number of admission days was calculated.Results: Percentage of cost attributed to Nitrofurantoin therapy out of total cost in urinary tract infection patient was less than percentage of cost attributed to inj Ceftriaxone in all five groups of patients and was found to be statistically significant (p <0.05). However, there was no statistically significant difference in average number of admission (IPD) days between groups of patients receiving tab nitrofurantoin and inj ceftriaxone (p>0.05).Conclusions: In current study authors found tab nitrofurantoin to be more cost effective than inj ceftriaxone as an empirical therapy in UTI patients.

Cost-Consequence Analysis of Single-Dose Dalbavancin Versus Standard of Care for the Treatment of Acute Bacterial Skin and Skin Structure Infections in a Multisite Healthcare System

2020 ◽  
Author(s):  
Julia Gonzalez ◽  
Diana Carolina Andrade ◽  
JianLi Niu
Keyword(s):  
Healthcare System ◽  
Treatment Success ◽  
Standard Of Care ◽  
Cost Of Care ◽  
Secondary Outcome ◽  
Total Cost ◽  
Skin Structure ◽  
Cost Consequence ◽  
The Difference ◽  
The Cost

Abstract Background Acute bacterial skin and skin structure infections (ABSSSIs) are common infectious diseases that cause a significant economic burden on the healthcare system. This study aimed to compare the cost-effectiveness of dalbavancin vs standard of care (SoC) in the treatment of ABSSSI in a community-based healthcare system. Methods This was a retrospective study of adult patients with ABSSSI treated with dalbavancin or SoC during a 27-month period. Patients were matched based on age and body mass index. The primary outcome was average net cost of care to the healthcare system per patient, calculated as the difference between reimbursement payments and the total cost to provide care to the patient. The secondary outcome was proportion of cases successfully treated, defined as no ABSSSI-related readmission within 30 days after the initiation of treatment. Results Of the 418 matched patients, 209 received SoC and 209 received dalbavancin. The average total cost of care per patient was greater with dalbavancin vs SoC ($4770 vs $2709, P &lt; .0001). The average reimbursement per patient was $3084 with dalbavancin vs $2633 SoC (P = .527). The net cost, calculated as revenue minus total cost, was $1685 with dalbavancin vs $75 with SoC (P = .013). The overall treatment success rate was 74% with dalbavancin vs 85% with SoC (P = .004). Conclusions Dalbavancin was more costly than SoC for the treatment of ABSSSI, with a higher 30-day readmission rate. Dalbavancin does not offer an economic or efficacy advantage.

Abstract WP382: The Cost of Ischemic Stroke: The Superiority of Marginal over Total Cost Estimation and Its Impact on National Cost Estimates

Stroke ◽  
2013 ◽  
Vol 44 (suppl_1) ◽  
Author(s):  
Annie N Simpson ◽  
Charles Ellis ◽  
Abby S Kazley ◽  
Heather S Bonilha ◽  
James S Zoller
Keyword(s):  
South Carolina ◽  
Ischemic Stroke ◽  
Cost Of Illness ◽  
Cost Of Care ◽  
Control Group ◽  
Medicare Beneficiaries ◽  
Comorbid Conditions ◽  
Total Cost ◽  
Economic Decision Making ◽  
The Cost

Introduction Cost of illness for ischemic stroke has historically been reported as mean cost per case over a time period. Such cost include expenditures made for comorbid conditions, and may result in an over-estimation of the economic burden of stroke on the nation. Without accurate estimates, policymakers cannot plan appropriately for the ageing US population. Hypothesis The 1-year marginal cost of stroke is less than the 1-year total cost of stroke for South Carolina (SC) Medicare beneficiaries. Methods A cost of illness analysis was performed from the Medicare perspective. SC Medicare billing files for 2004 and 2005 were used to estimate the mean 12 month cost of stroke for 2,976 Medicare beneficiaries hospitalized for ischemic Stroke in 2004. Using nearest neighbor propensity score matching, a control group of 5,952 non-stroke beneficiaries were matched on age, race, gender and comorbid conditions. Results The total cost estimated for stroke patients for 1 year was $81.3 million. The cost for the matched comparison group without stroke, but with similar age, gender, race and comorbid conditions was significantly less at $54.4 million (p<0.0001). Thus, the 2004 marginal costs to Medicare due to ischemic stroke in SC are estimated to be $26.9 million. If this difference is inflated to 2012 dollars and projected to estimate the 2012 one year burden of ischemic stroke nationally, total annual stroke costs would be overestimated by $4.89 billion. Conclusions Accurate estimates of cost of care for conditions, such as stroke, that are common in older patients with a high rate of comorbid conditions require the use of a marginal costing approach. Overestimation of cost of care for stroke may lead to erroneous funding allocation and prediction of larger savings than realizable from stroke treatment and prevention programs. Given the trend of policies based on cost savings, overestimation poses a danger of limiting services that patients may receive. Thus, it is important to use marginal costing for stroke program estimates, especially with the increasing public focus on evidence-based economic decision making to be expected with health reform.

Delayed Tuberculosis Diagnosis in a Low Incidence Country and its Effect on Cost of Care

2021 ◽  
Author(s):  
James O'Connell ◽  
Niamh Reidy ◽  
Cora McNally ◽  
Debbi Stanistreet ◽  
Eoghan de Barra ◽  
...  
Keyword(s):  
Health Care ◽  
Health Care Provider ◽  
Care Provider ◽  
Delayed Diagnosis ◽  
Signs And Symptoms ◽  
Cost Of Care ◽  
Global Priority ◽  
Low Incidence ◽  
The Cost ◽  
Health Care Records

Abstract Background Tuberculosis elimination (TB) is a global priority that requires high-quality timely care to be achieved. In low TB incidence countries such as Ireland, delayed diagnosis is common. Despite cost being central to policy making, it is not known if delayed care affects care cost among TB patients in a low-incidence setting. Methods Health care records of patients with signs and symptoms of TB evaluated by a tertiary service in Ireland between July 1st 2018 and December 31st 2019 were reviewed to measure and determine predictors of patient-related delays, health care-provider related delay and the cost of TB care. Benchmarks against which the outcomes were compared were derived from the literature. Results Thirty-seven patients were diagnosed with TB and 51% (19/37) had pulmonary TB (PTB). The median patient-related delay was 60 days among those with PTB, greater than the benchmark derived from the literature (38 days). The median health care provider-related delay among patients with PTB was 16 days and, although similar to the benchmark (median 22 days, minimum 11 days, maximum 36 days) could be improved. The health care-provider related delay among patients with EPTB was 66 days, greater than the benchmark (42 days). The cost of care was €8298, and while similar to that reported in the literature (median €9,319, minimum €6,486, maximum €14,750) could be improved. Patient-related delay among those with PTB predicted care costs. Conclusion Patient-related and health care-related delays in TB diagnosis in Ireland must be reduced. Initiatives to do so should be resourced.

Consumer Cost-Sharing as a Means to Reduce Health Care Costs

PEDIATRICS ◽  
1980 ◽  
Vol 65 (1) ◽  
pp. 168-170
Author(s):  
Stephen M. Davidson ◽  
John P. Connelly ◽  
R. Don Blim ◽  
James E. Strain ◽  
H. Doyl Taylor
Keyword(s):  
Health Care ◽  
Health Care Costs ◽  
Cost Sharing ◽  
Cost Of Care ◽  
National Commission ◽  
Insurance Policies ◽  
National Medical ◽  
Use Of Services ◽  
The Cost ◽  
Care Costs

The National Commission on the Cost of Medical Care1 states in part (Recommendation 2) that "insurance policies should include provisions through which the consumer shares in the cost of care received, at the time of service, for selected benefits and for selected groups...." These cost-sharing provisions are expected to reduce national medical care expenditures by encouraging consumers to reduce their use of services in order to avoid paying additional money out of their own pockets. They will thus moderate the demand-inducing tendency of insurance, leading the rational consumer to seek only necessary services and to forego those services contributing to what is believed to be over-utilization. As the Commission states in its supporting statement:

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