Does €1 Per Prescription Make a Difference? Impact of a Capped Low-Intensity Pharmaceutical Co-Payment

Pilar Garcia-Gomez, Toni Mora and Jaume Puig-Junoy ()
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Jaume Puig-Junoy: Universitat Pompeu Fabra (UPF)

Applied Health Economics and Health Policy, 2018, vol. 16, issue 3, No 12, 407-414

Abstract: Abstract Background Increasing patient contributions and reducing the population exempt from pharmaceutical co-payment and co-insurance rates were one of the most common measures in the reforms adopted in Europe during 2010–2015. Objective We estimated the association between the introduction of a capped co-payment of €1 per prescription and drug consumption of the publicly insured population of Catalonia (Spain). Methods We used administrative data on monthly pharmaceutical consumption (defined daily doses [DDDs]) from January 2012 to December 2014, for a representative sample of 85,000 people. Results Our results showed that consumption increased in the 2 months previous to the introduction of the measure, and fell with the introduction of the ‘Euro per prescription’ co-payment. The average net response associated with the reform (including anticipation) was a reduction of 4.1 DDDs per person per month, representing a 6.4% reduction. The decrease in pharmaceutical consumption was larger for those individuals who had free medicines prior to the reform compared with those who already paid a co-insurance rate (9.7 vs. 1.4 DDDs per person per month). The largest reduction in DDDs per person occurred in the following groups: dermatologic drugs, antihypertensives, non-insulin antidiabetic drugs, insulin antidiabetic drugs, and laxatives. Conclusion A uniform capped low co-payment may give rise to a major reduction in drug consumption to a much greater extent among those who previously had free prescriptions.

Date: 2018
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DOI: 10.1007/s40258-018-0382-x

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