Beshears John, Choi James J, Laibson David, Madrian Brigitte C
Harvard Business School and NBER, Soldiers Field, Boston, MA 02163, United States.
Yale School of Management and NBER, 165 Whitney Avenue, New Haven, CT 06520, United States.
Organ Behav Hum Decis Process. 2021 Mar;163:6-16. doi: 10.1016/j.obhdp.2019.02.001. Epub 2019 Feb 15.
Home-delivered prescriptions have no delivery charge and lower copayments than prescriptions picked up at a pharmacy. Nevertheless, when home delivery is offered on an opt-in basis, the take-up rate is only 6%. We study a program that makes active choice of either home delivery or pharmacy pick-up a requirement for insurance eligibility. The program introduces an implicit default for those who don't make an active choice: pharmacy pick-up insurance subsidies. Under this program, 42% of eligible employees actively choose home delivery, 39% actively choose pharmacy pick-up, and 19% make no active choice and are assigned the implicit default. Individuals who financially benefit most from home delivery are more likely to choose it. Those who benefit least from insurance subsidies are more likely to make no active choice and lose those subsidies. The implicit default incentivizes people to make an active choice, thereby playing a key role in choice architecture.
送药上门的处方没有配送费，且自付费用比在药店取药更低。然而，当送药上门是基于选择加入的方式提供时，其使用率仅为6%。我们研究了一个项目，该项目将主动选择送药上门或在药店取药作为获得保险资格的一项要求。该项目为那些没有做出主动选择的人引入了一个隐性默认选项：在药店取药——保险补贴。在这个项目下，42%符合条件的员工主动选择送药上门，39%主动选择在药店取药，19%没有做出主动选择并被分配到隐性默认选项。从送药上门中经济受益最多的个人更有可能选择它。从保险补贴中受益最少的人更有可能不做出主动选择并失去那些补贴。隐性默认选项激励人们做出主动选择，并因此在选择架构中发挥关键作用。
