Author Interviews, Cost of Health Care, JAMA, Surgical Research / 07.09.2021
Increased Cost Sharing Linked to Patients Delaying Care for Appendicitis
MedicalResearch.com Interview with:
[caption id="attachment_58033" align="alignleft" width="133"] Dr. Loehrer[/caption]
Andrew P. Loehrer, MD, MPH
Assistant Professor
Department of Surgery, Division of Surgical Oncology
Dartmouth-Hitchcock
MedicalResearch.com: What is the background for this study?
Response: Patient cost sharing represents the portion of costs covered by insurance that individuals pay out of pocket, including deductibles, co-payment, and co-insurance. Cost sharing is increasingly common and also increasingly expensive for patients with commercial health insurance across the United States.
While designed to increase patient responsibility for health care spending, prior work has shown that higher cost sharing is also associated with decreased use of health care overall, both needed and discretionary. However, little work has been done as to how high cost sharing may affect common and costly conditions like acute appendicitis and acute diverticulitis.
Dr. Loehrer[/caption]
Andrew P. Loehrer, MD, MPH
Assistant Professor
Department of Surgery, Division of Surgical Oncology
Dartmouth-Hitchcock
MedicalResearch.com: What is the background for this study?
Response: Patient cost sharing represents the portion of costs covered by insurance that individuals pay out of pocket, including deductibles, co-payment, and co-insurance. Cost sharing is increasingly common and also increasingly expensive for patients with commercial health insurance across the United States.
While designed to increase patient responsibility for health care spending, prior work has shown that higher cost sharing is also associated with decreased use of health care overall, both needed and discretionary. However, little work has been done as to how high cost sharing may affect common and costly conditions like acute appendicitis and acute diverticulitis. 
Dr. Shaker[/caption]
Marcus S. Shaker, MD
Associate Professor of Pediatrics
Associate Professor of Community and Family Medicine
Dartmouth-Hitchcock Medical Center
MedicalResearch.com: What is the background for this study?
Response: There are two peanut allergy treatments that are being evaluated for potential FDA approval—an orally administered treatment and an epicutaneous (skin based) treatment. Both have tremendous potential benefit. The focus of our study was to explore the range of health and economic benefits in terms of establishing pathways for how each therapy could be cost effective.
We want to be clear that our purpose was not to suggest one therapy is or is not cost effective at present. That would be a ridiculous statement to make regarding two treatments that not only lack FDA approval, but do not have established pricing. Rather, we used preliminary inputs that are presently available to create as robust a model as we could to better determine the individual paths that would make them more or less cost-effective.