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Researchers found that out-of-pocket costs for MS drugs showed the steepest monthly increase. People taking these medications paid an average out-of-pocket cost of $15 a month in 2004 compared to an average of $309 a month in 2016, meaning their out-of-pocket costs were 20 times higher over the 12-year period.

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Another notable finding was that costs for people in high-deductible health plans were twice as high for monthly out-of-pocket expense compared to those not in high-deductible plans. In 2016, people with MS in a high-deductible plan paid an average of $661 per month compared to $246 a month for those not in a high-deductible plan.

Researchers also found that out-of-pocket costs vary widely within neurologic conditions. For example, when looking at total costs over two years, 5 percent of people with MS paid a total of just $90 while another 5 percent paid $9,855 or more.

In this work, in order to reveal protein surface patterns in a systems biology framework, we analyze the similarity among the surface cavities by investigating the features of the pocket similarity network such as the community structure, the small-world property, the scale-free characteristic, and the hubs.

And they do appear to lower costs. Chernew and colleagues (in Health Affairs) attribute 20 percent of the slowing in health care costs to rising out-of-pocket payments. In other words, when the insured bears more of the cost, the insured becomes more price-sensitive. Another recent study by RAND, USC, and Towers Watson predicts a health care spending drop of $57 billion if HDHPs were taken up by 50 percent of employers.

Probably, fixes will be designed to protect those patients and families at greatest risk to avoid unintended health consequences. More people (who can afford to do so) will learn how to use health savings accounts to help lessen the financial burden. However, we ophthalmologists and our staffs must be sensitive to a new and confusing reality for many of our patients. This will mean increased up-front transparency about charges and patient financial responsibility. And it will mean recognizing that some patients may tragically forgo needed services and medications as they unexpectedly discover that the costs will be out-of-pocket. ff782bc1db