Out-of-Pocket Costs Heighten Expected Pain

High co-pays lead patients to anticipate more physical pain and to delay or skip needed care, according to a new study.

Updated on Nov. 4, 2026 in Healthcare

Out-of-Pocket Costs Heighten Expected Pain

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Have you ever skipped or delayed a medical test because of its cost?

Researchers led by Helen Colby of Carnegie Mellon University found that people told they would face high medical co-pays predicted greater physical pain. The study, published in Psychology & Marketing, included three experiments with 300, 350, and 400 American adults.

Why it matters

Financial distress appears to spill over into expectations of pain, triggering anxiety that may discourage people from scheduling necessary treatment. Low-income or financially strained patients may be especially likely to delay medical care.

Three experiments with 300, 350, and 400 American adults tested co-pays of $53, $787, and $1,120 against a no-co-pay condition. The results show how expected costs shape pain predictions, though real-world treatment decisions were not measured.

The players

Helen Colby

Colby is an assistant teaching professor of marketing at Carnegie Mellon University who led the study on co-pays and pain expectations.

Carnegie Mellon University

Carnegie Mellon University is a private research university in Pittsburgh whose researchers conducted and publicized the study.

The details

Participants were randomly assigned to be told either the amount they would have to pay or that there would be no co-pay. Those told of high prices predicted higher physical pain and were less willing to schedule appointments.

Oct. 28, 2026: Carnegie Mellon University released its news report on the study.
Nov. 4, 2026: HealthDay published an article reporting the findings.

Healthcare Landscape

The study extends consumer-psychology research from Carnegie Mellon's marketing department into healthcare, showing that price cues shape patients' expectations about treatment. It suggests that cost transparency and co-pay design may affect not only affordability but also how much pain patients anticipate.

Patients facing high co-pays may anticipate more pain and be less inclined to schedule necessary procedures, potentially delaying diagnosis or treatment. Asking providers about expected costs before a procedure may help reduce financial surprises and uncertainty.

The takeaway

Cost concerns can affect how people feel about a procedure before it happens, not just whether they can pay for it. Discussing expected out-of-pocket costs with a provider in advance may help patients plan and avoid delaying needed care.