prescription drugs

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1) Google’s PowerMeter is dead. Long live Google’s PowerMeter. Thoughts on why it didn’t take off here.

2) Choice overload at a young age. (See page 4 and markers)

3) Morningstar on “The Benefits of a Financial Nudge

4) FICO scores for medical adherence?

5) Early prognosis for tax receipt. It doesn’t much change how Americans feel about paying their taxes.

6) The Winner’s Curse in its most basic form: Spending $28 for a $25 gift card as part of an Ebay auction.

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Assorted links

1) Celebrating the transparent Rx bottle.

2) Should your credit score take into account your savings habits?

3) Imagine eating a huge bowl of M&Ms…Still hungry?

4) Self-checkout lanes = fewer impulse purchases.

5) Marketing nudge – how opt-in box for emails dropped conversion rate by 17 percent. Explanations?

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Assorted links

1) Nudging rules for charities.
2) Exercise meets commerce.
3) Just buy this one – a site that radically simplifies shopping (and requires a lot of trust in its consumer ratings). Hat tip: Rory Sutherland.
4) Washington State posts surgical infection rates at all state hospitals online. Hat tip: Maria Kovell.
5) Electronic prescriptions lead to higher non-adherence? Strange. Hat tip: Gilad Buchman.
6) A version of RECAP for bank loan fees in India. Hat tip: Mostly Economics.
7) What’s the secret to marketing the McRib? Artificial scarcity.

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From the French artist Mathieu Lehanneur, reported by NPR. It’s still just a concept but the basic idea is to have the “orb” get sicker as the patient neglects to take her medicine.

The boy…has asthma. His asthma medicine is in that light-bulb looking thing on the night table. I think it is a kind of inhaler.

If the boy doesn’t take his medicine on time, the inhaler will change color “displaying its own physiological problem and indicating to the patient the urgency of taking the medication.”

In other words, the device “gets sick” if the boy doesn’t use it. And when he does, it gets better (and so does he!) This design taps into our desire to help others feel better. Clever, no?

A TED talk by the artist is here. The part about patient non-adherence starts at the 7:30 minute mark.

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In 2006, a group of researchers studied senior citizens’ decision about Medicare Part D plans. Plenty of seniors got confused and picked suboptimal plans. It sounded like bad news, but there was a potential bright spot: If their doctors helped them out, presumably they’d make better choices.

In a new study (gated here) of medical students and residents at a leading (unnamed) hospital looking at simplified versions of 3, 10 and 20 Medicare Part D plans, the researchers found that more than two-thirds of doctors picked the right one. However, poor choices increased with the number of plans offered. Keep in mind that most states offer more than 50 plans whose descriptions are not nearly as streamlined as the ones in this study. Discouragingly, physician confidence rose as the number of mistakes increased.

But doctors with better numerical skills performed better with their choices. Unfortunately, there’s no easy way to use that piece of information when making physician choices today. if you’re picking a primary care physician from a health insurance provider’s list, you are often told what medical school a doctor attended, but not what that doctor majored in back in college.

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In order to increase the rate at which patients renew (and hopefully take) their medicines, CVS experimented with moving the point at which users are asked if they’d like automatic refills when filling out an online order. By moving the question from after the prescription had been filled to before, CVS says sign-up rates doubled. Reports the WSJ:

The test prompt required users to click either yes or no when asked about auto refills, rather than just offering a box to be checked for more information, (says Bari Harlam, senior VP at CVS Caremark). “It’s both things,” she says. “This is very much about using clear, plain language, and also offering it at the right time.”

More on the CVS results can be found here.

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Two MIT economists recently published the most comprehensive study to date on seniors’ choices under Medicare Part D, the government’s massive prescription drug program passed in by Congress in 2003. Looking at nearly half a million seniors participating in Part D, Jason Abaluck and Jonathan Gruber tracked both the choice of plan and prescriptions filled, and then compared the two to see if those individuals could have selected a different available drug benefit plan and saved money. They found that 70 percent of seniors are not choosing the most efficient plans, meaning there were unselected alternatives that offered better risk protection for less money. If these seniors opted for the best plan, Abaluck and Gruber estimate they could have saved about 27 percent of their total costs.

Instead, it seems that seniors are making three major errors in their plan selection:

1) Seniors weight plan premiums far more than expected out-of-pocket costs.

2) Seniors choose to pay for extras like donut hole coverage and low deductibles that they don’t need. They also prefer plans that cover more drugs, but they lack the foresight to decide which plans cover drugs they might need in the future.

3) Seniors do not appreciate the risk-reducing aspects of plans themselves. For instance, they aren’t willing to pay more for plans with lower variance in expected spending, which could save them money if there is a spike in prescription drug costs on year.

The bottom line is that seniors could have saved quite a bit of money without sacrificing many benefits if they had chosen one of the lowest cost options in their state. Don’t be turned off just because a plan is inexpensive. It may fit you just fine.

A gated version of the paper is here.


Epocrates helps compile prescription drug lists – even when you’ve forgotten the name and only remember the color, size, and shape of the pills.


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