title: Facing Financial Hardship: Patients' Views on Clinical Trade-offs in Exchange for Cost Savings.
abstract: As more patients enroll in health insurance with high out-of-pocket costs, provider-patient cost discussions are of growing importance. Little is known about how patients want providers to engage in cost conversations. We surveyed 842 chronically ill adults seeking financial help to examine preferences around treatment trade-offs in 3 areas-convenience, side effects, and efficacy and whether preferences changed with different savings. To save money, half of patients were willing to endure inconvenience (increased dosing), with no difference by magnitude of savings ($50 vs $150 per month). Few participants were willing to tolerate side effects or reduced efficacy.
authors.affiliation: Department of Medicine, University of California, San Francisco (Dr Lowenstein); Departments of Family Medicine and Community Health (Dr Cannuscio) and Medicine (Dr Grande), University of Pennsylvania, Philadelphia; Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia (Drs Cannuscio and Grande); and College of Arts & Sciences, University of Pennsylvania, Philadelphia (Ms Tardif).
authors.forename: Margaret
authors.initials: M
authors.lastname: Lowenstein
authors.forename: Carolyn
authors.initials: C
authors.lastname: Cannuscio
authors.forename: Madeleine
authors.initials: M
authors.lastname: Tardif
authors.forename: David
authors.initials: D
authors.lastname: Grande