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Related Experiment Video

Updated: Nov 5, 2025

The Adventures of Fundi Intervention Based on the Cognitive and Emotional Processing in Attention Deficit Hyperactive Disorder Patients

The Adventures of Fundi Intervention Based on the Cognitive and Emotional Processing in Attention Deficit Hyperactive Disorder Patients

Published on: June 12, 2020

Active choice, implicit defaults, and the incentive to choose.

John Beshears¹, James J Choi², David Laibson³

¹Harvard Business School and NBER, Soldiers Field, Boston, MA 02163, United States.

Organizational Behavior and Human Decision Processes

|May 14, 2021

Summary

This summary is machine-generated.

Requiring an active choice for prescription fulfillment, rather than opt-in, significantly increased home delivery uptake. An implicit default nudged users toward making a decision, improving program engagement.

Keywords:

Active choice Defaults Implicit defaults Incentives

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Last Updated: Nov 5, 2025

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Published on: June 12, 2020

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Published on: January 9, 2016

Area of Science:

Behavioral Economics
Health Services Research
Public Health Policy

Background:

Home-delivered prescriptions offer cost savings (no delivery charge, lower copayments) compared to pharmacy pick-up.
Opt-in programs for home prescription delivery show low uptake rates (only 6%).
Understanding factors influencing prescription fulfillment choices is crucial for optimizing healthcare access and cost-effectiveness.

Purpose of the Study:

To evaluate the impact of an active choice program on prescription fulfillment method selection.
To assess the effectiveness of an implicit default strategy in driving user decisions for home delivery versus pharmacy pick-up.
To analyze how financial incentives influence individuals' choices in prescription fulfillment.

Main Methods:

A program was implemented requiring active choice between home delivery and pharmacy pick-up for insurance eligibility.
An implicit default (pharmacy pick-up without insurance subsidies) was established for non-responders.
Choice outcomes and influencing factors were analyzed among eligible employees.

Main Results:

Active choice led to a 42% uptake of home delivery and 39% for pharmacy pick-up.
19% of individuals made no active choice and defaulted to pharmacy pick-up without subsidies.
Individuals with greater financial benefit from home delivery were more likely to choose it; those benefiting least from subsidies were more likely to default.

Conclusions:

Mandating active choice significantly increases engagement with home prescription delivery services.
Implicit defaults serve as a powerful tool in choice architecture, incentivizing active decision-making.
Choice design can effectively steer individuals toward more cost-effective and convenient prescription fulfillment methods.