Impact of high deductible insurance on out-of-pocket cost burden in breast cancer.

545Background: High-deductible health plans (HDHP) requiring out-of-pocket (OOP) costs for most services may place heavy economic burden on patients. This study examined the impact of modern HDHPs on OOP costs among women with early-stage breast cancer. Methods: We included 886 women with incident early-stage breast cancer, age 25 to 64 years, who were insured by employers that mandated a transition from low-deductible ( = $1000/year) coverage, and 3099 exact matched contemporaneous patients whose employers offered only low-deductible plans. Measures were pharmacy and medical OOP costs per person-year. Medical services were categorized as inpatient, emergency room (ER), primary care visits, and outpatient care which included specialist visits, radiology, lab tests, and chemotherapy. We calculated OOP costs as the sum of deductibles, copays, and coinsurance. Effect estimates of changes between study groups were established using difference-in-differences analyses. Resu...