Most health services in Canada are covered under the Canada Health Act. One major exception to this coverage is outpatient drugs. Most provinces have instituted cost sharing programs with patients, such as co-payments and deductible plans for prescription drugs. Researchers in the US found overall health care expenditures are reduced when patients make co-payments for prescription drugs, physician visits, or hospital admissions. Dr. Xin Li is investigating whether the opposite is true in Canada, since other health services are publicly funded. Xin is analyzing whether a co-payment plan for medications causes patients to use other “free” health services as substitutes for medication, resulting in an overall increase in health care expenditures. She is focusing on patients with rheumatoid arthritis because expensive drugs are increasingly the mainstay for treatment of the disease. This research will clarify the impact of user fees on the use of health care services among patients with rheumatoid arthritis in BC. The findings could be used to identify the most cost-effective approach for treating rheumatoid arthritis, and potentially, many other conditions.