• Tatyana Avilova Institute of Social Science, the University of Tokyo

• Kenneth Mori McElwain Professor, Institute of Social Science, the University of Tokyo

Previous research has documented that as patient cost sharing – the proportion of health care expenses that individuals must pay out of pocket – decreases, patients’ demand for and spending on health care services increase. This includes demand for and spending on prescription drugs. However, there is limited evidence about whether changes in patient cost sharing have heterogeneous effects by patient sex and type of prescription drug treatment. I study this question in the context of the Japanese health care system, where universal access to most health care services at standardized prices and the age-dependent patient cost sharing scheme address the challenges of conducting this research in other countries. I find statistically significant differences in spending between women and men by type of treatment. Evidence further suggests that spending increases through either more patients beginning treatment or existing patients using more prescription drugs, but not through existing patients switching to more expensive medications.

Tatyana Avilova is a Research Associate at the Institute of Social Science at the University of Tokyo. Her research in health economics and economic education studies how institutional policies and interventions impact prescription drug use and students’ choice of college major. She has also studied women’s labor force participation as an intern at RIETI and the work-life balance of nurses in Ibaraki Prefecture as a Fulbright Fellow at the University of Tsukuba. She received her B.A. in Economics from Harvard College and her Ph.D. in Economics from Columbia University.