The effect of changes in cost sharing on the consumption of prescription and over-the-counter medicines in Catalonia

Many universal health care systems have increased the share of the price of medicines paid by the patient to reduce the cost pressure faced after the Great Recession. This paper assesses the impact of cost-sharing changes on the propensity to consume prescription and over-the-counter medicines in Ca...

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Autores: Martínez-Jiménez, Mario, García-Gómez, Pilar, Puig i Junoy, Jaume
Tipo de recurso: artículo
Estado:Versión publicada
Fecha de publicación:2021
País:España
Institución:Varias* (Consorci de Biblioteques Universitáries de Catalunya, Centre de Serveis Científics i Acadèmics de Catalunya)
Repositorio:Recercat. Dipósit de la Recerca de Catalunya
OAI Identifier:oai:recercat.cat:10230/58393
Acceso en línea:http://hdl.handle.net/10230/58393
http://dx.doi.org/10.3390/ijerph18052562
Access Level:acceso abierto
Palabra clave:Prescription drugs
Healthcare financing
Public policy
Cost-sharing
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spelling The effect of changes in cost sharing on the consumption of prescription and over-the-counter medicines in CataloniaMartínez-Jiménez, MarioGarcía-Gómez, PilarPuig i Junoy, JaumePrescription drugsHealthcare financingPublic policyCost-sharingMany universal health care systems have increased the share of the price of medicines paid by the patient to reduce the cost pressure faced after the Great Recession. This paper assesses the impact of cost-sharing changes on the propensity to consume prescription and over-the-counter medicines in Catalonia, a Spanish autonomous community, affected by three new cost-sharing policies implemented in 2012. We applied a quasi-experimental difference-in-difference method using data from 2010 to 2014. These reforms were heterogeneous across different groups of individuals, so we define three intervention groups: (i) middle-income working population—co-insurance rate changed from 40% to 50%; (ii) low/middle-income pensioners—from free full coverage to 10% co-insurance rate; (iii) unemployed individuals without benefits—from 40% co-insurance rate to free full coverage. Our control group was the low-income working population whose co-insurance rate remained unchanged. We estimated the effects on the overall population as well as on the group with long-term care needs. We evaluated the effect of these changes on the propensity to consume prescription or over-the-counter medicines, and explored the heterogeneity effects across seven therapeutic groups of prescription medicines. Our findings showed that, on average, these changes did not significantly change the propensity to consume prescription or over-the-counter medicines. Nonetheless, we observed that the propensity to consume prescription medicines for mental disorders significantly increased among unemployed without benefits, while the consumption of prescribed mental disorders medicines for low/middle-income pensioners with long-term care needs decreased after becoming no longer free. We conclude that the propensity to consume medicines was not affected by the new cost-sharing policies, except for mental disorders. However, our results do not preclude potential changes in the quantity of medicines individuals consume.MDPI202320232021info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionapplication/pdfapplication/pdfhttp://hdl.handle.net/10230/58393http://dx.doi.org/10.3390/ijerph18052562reponame:Recercat. Dipósit de la Recerca de Catalunyainstname:Varias* (Consorci de Biblioteques Universitáries de Catalunya, Centre de Serveis Científics i Acadèmics de Catalunya)InglésInternational Journal of Environmental Research and Public Health. 2021 Mar 1;18(5):2562© 2021 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).http://creativecommons.org/licenses/by/4.0/info:eu-repo/semantics/openAccessoai:recercat.cat:10230/583932026-05-29T05:05:01Z
dc.title.none.fl_str_mv The effect of changes in cost sharing on the consumption of prescription and over-the-counter medicines in Catalonia
title The effect of changes in cost sharing on the consumption of prescription and over-the-counter medicines in Catalonia
spellingShingle The effect of changes in cost sharing on the consumption of prescription and over-the-counter medicines in Catalonia
Martínez-Jiménez, Mario
Prescription drugs
Healthcare financing
Public policy
Cost-sharing
title_short The effect of changes in cost sharing on the consumption of prescription and over-the-counter medicines in Catalonia
title_full The effect of changes in cost sharing on the consumption of prescription and over-the-counter medicines in Catalonia
title_fullStr The effect of changes in cost sharing on the consumption of prescription and over-the-counter medicines in Catalonia
title_full_unstemmed The effect of changes in cost sharing on the consumption of prescription and over-the-counter medicines in Catalonia
title_sort The effect of changes in cost sharing on the consumption of prescription and over-the-counter medicines in Catalonia
dc.creator.none.fl_str_mv Martínez-Jiménez, Mario
García-Gómez, Pilar
Puig i Junoy, Jaume
author Martínez-Jiménez, Mario
author_facet Martínez-Jiménez, Mario
García-Gómez, Pilar
Puig i Junoy, Jaume
author_role author
author2 García-Gómez, Pilar
Puig i Junoy, Jaume
author2_role author
author
dc.subject.none.fl_str_mv Prescription drugs
Healthcare financing
Public policy
Cost-sharing
topic Prescription drugs
Healthcare financing
Public policy
Cost-sharing
description Many universal health care systems have increased the share of the price of medicines paid by the patient to reduce the cost pressure faced after the Great Recession. This paper assesses the impact of cost-sharing changes on the propensity to consume prescription and over-the-counter medicines in Catalonia, a Spanish autonomous community, affected by three new cost-sharing policies implemented in 2012. We applied a quasi-experimental difference-in-difference method using data from 2010 to 2014. These reforms were heterogeneous across different groups of individuals, so we define three intervention groups: (i) middle-income working population—co-insurance rate changed from 40% to 50%; (ii) low/middle-income pensioners—from free full coverage to 10% co-insurance rate; (iii) unemployed individuals without benefits—from 40% co-insurance rate to free full coverage. Our control group was the low-income working population whose co-insurance rate remained unchanged. We estimated the effects on the overall population as well as on the group with long-term care needs. We evaluated the effect of these changes on the propensity to consume prescription or over-the-counter medicines, and explored the heterogeneity effects across seven therapeutic groups of prescription medicines. Our findings showed that, on average, these changes did not significantly change the propensity to consume prescription or over-the-counter medicines. Nonetheless, we observed that the propensity to consume prescription medicines for mental disorders significantly increased among unemployed without benefits, while the consumption of prescribed mental disorders medicines for low/middle-income pensioners with long-term care needs decreased after becoming no longer free. We conclude that the propensity to consume medicines was not affected by the new cost-sharing policies, except for mental disorders. However, our results do not preclude potential changes in the quantity of medicines individuals consume.
publishDate 2021
dc.date.none.fl_str_mv 2021
2023
2023
dc.type.none.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
format article
status_str publishedVersion
dc.identifier.none.fl_str_mv http://hdl.handle.net/10230/58393
http://dx.doi.org/10.3390/ijerph18052562
url http://hdl.handle.net/10230/58393
http://dx.doi.org/10.3390/ijerph18052562
dc.language.none.fl_str_mv Inglés
language_invalid_str_mv Inglés
dc.relation.none.fl_str_mv International Journal of Environmental Research and Public Health. 2021 Mar 1;18(5):2562
dc.rights.none.fl_str_mv http://creativecommons.org/licenses/by/4.0/
info:eu-repo/semantics/openAccess
rights_invalid_str_mv http://creativecommons.org/licenses/by/4.0/
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv application/pdf
application/pdf
dc.publisher.none.fl_str_mv MDPI
publisher.none.fl_str_mv MDPI
dc.source.none.fl_str_mv reponame:Recercat. Dipósit de la Recerca de Catalunya
instname:Varias* (Consorci de Biblioteques Universitáries de Catalunya, Centre de Serveis Científics i Acadèmics de Catalunya)
instname_str Varias* (Consorci de Biblioteques Universitáries de Catalunya, Centre de Serveis Científics i Acadèmics de Catalunya)
reponame_str Recercat. Dipósit de la Recerca de Catalunya
collection Recercat. Dipósit de la Recerca de Catalunya
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