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

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dc.contributor.author Martínez-Jiménez, Mario
dc.contributor.author García-Gómez, Pilar
dc.contributor.author Puig i Junoy, Jaume
dc.date.accessioned 2023-11-28T07:07:32Z
dc.date.available 2023-11-28T07:07:32Z
dc.date.issued 2021
dc.identifier.citation Martínez-Jiménez M, García-Gómez P, Puig-Junoy J. The effect of changes in cost sharing on the consumption of prescription and over-the-counter medicines in Catalonia. IJERPH. 2021 Mar 1;18(5):2562. DOI: 10.3390/ijerph18052562
dc.identifier.issn 1660-4601
dc.identifier.uri http://hdl.handle.net/10230/58393
dc.description.abstract 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.
dc.format.mimetype application/pdf
dc.language.iso eng
dc.publisher MDPI
dc.relation.ispartof International Journal of Environmental Research and Public Health. 2021 Mar 1;18(5):2562
dc.rights © 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/).
dc.rights.uri http://creativecommons.org/licenses/by/4.0/
dc.title The effect of changes in cost sharing on the consumption of prescription and over-the-counter medicines in Catalonia
dc.type info:eu-repo/semantics/article
dc.identifier.doi http://dx.doi.org/10.3390/ijerph18052562
dc.subject.keyword Prescription drugs
dc.subject.keyword Healthcare financing
dc.subject.keyword Public policy
dc.subject.keyword Cost-sharing
dc.rights.accessRights info:eu-repo/semantics/openAccess
dc.type.version info:eu-repo/semantics/publishedVersion

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