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A Systematic Review of Cost-Sharing Strategies Used within Publicly-Funded Drug Plans in Member Countries of the Organisation for Economic Co-Operation and Development

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  • Lianne Barnieh
  • Fiona Clement
  • Anthony Harris
  • Marja Blom
  • Cam Donaldson
  • Scott Klarenbach
  • Don Husereau
  • Diane Lorenzetti
  • Braden Manns

Abstract

Background: Publicly-funded drug plans vary in strategies used and policies employed to reduce continually increasing pharmaceutical expenditures. We systematically reviewed the utilization of cost-sharing strategies and physician-directed prescribing regulations in publicly-funded formularies within member nations of the Organization of Economic Cooperation and Development (OECD). Methods & Findings: Using the OECD nations as the sampling frame, a search for cost-sharing strategies and physician-directed prescribing regulations was done using published and grey literature. Collected data was verified by a system expert within the prescription drug insurance plan in each country, to ensure the accuracy of key data elements across plans. Conclusions: There was variable use of cost-containment strategies to limit pharmaceutical expenditures in publicly funded formularies within OECD countries. Further research is needed to determine the best approach to constrain costs while maintaining access to pharmaceutical drugs.

Suggested Citation

  • Lianne Barnieh & Fiona Clement & Anthony Harris & Marja Blom & Cam Donaldson & Scott Klarenbach & Don Husereau & Diane Lorenzetti & Braden Manns, 2014. "A Systematic Review of Cost-Sharing Strategies Used within Publicly-Funded Drug Plans in Member Countries of the Organisation for Economic Co-Operation and Development," PLOS ONE, Public Library of Science, vol. 9(3), pages 1-10, March.
    • Handle: RePEc:plo:pone00:0090434
    DOI: 10.1371/journal.pone.0090434
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    References listed on IDEAS

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    1. Berger, Michael & Six, Eva & Czypionka, Thomas, 2024. "Policy implications of heterogeneous demand reactions to changes in cost-sharing: patient-level evidence from Austria," LSE Research Online Documents on Economics 121162, London School of Economics and Political Science, LSE Library.
    2. Rättö, Hanna & Kurko, Terhi & Martikainen, Jaana E. & Aaltonen, Katri, 2021. "The impact of a co-payment increase on the consumption of type 2 antidiabetics – A nationwide interrupted time series analysis," Health Policy, Elsevier, vol. 125(9), pages 1166-1172.
    3. Liran Einav & Amy Finkelstein & Maria Polyakova, 2018. "Private Provision of Social Insurance: Drug-Specific Price Elasticities and Cost Sharing in Medicare Part D," American Economic Journal: Economic Policy, American Economic Association, vol. 10(3), pages 122-153, August.
    4. Berger, Michael & Pock, Markus & Reiss, Miriam & Röhrling, Gerald & Czypionka, Thomas, 2023. "Exploring the effectiveness of demand-side retail pharmaceutical expenditure reforms: cross-country evidence from weighted-average least squares estimation," LSE Research Online Documents on Economics 116928, London School of Economics and Political Science, LSE Library.
    5. Gourzoulidis, George & Kourlaba, Georgia & Stafylas, Panagiotis & Giamouzis, Gregory & Parissis, John & Maniadakis, Nikolaos, 2017. "Association between copayment, medication adherence and outcomes in the management of patients with diabetes and heart failure," Health Policy, Elsevier, vol. 121(4), pages 363-377.
    6. Jelena Arsenijevic & Milena Pavlova & Bernd Rechel & Wim Groot, 2016. "Catastrophic Health Care Expenditure among Older People with Chronic Diseases in 15 European Countries," PLOS ONE, Public Library of Science, vol. 11(7), pages 1-18, July.
    7. M. Fasihul Alam & David Cohen & Frank Dunstan & Dyfrig Hughes & Philip Routledge, 2018. "Impact of the phased abolition of co‐payments on the utilisation of selected prescription medicines in Wales," Health Economics, John Wiley & Sons, Ltd., vol. 27(1), pages 236-243, January.
    8. Han, Euna & Chae, Su-Mi & Kim, Nam-Soon & Park, Sylvia, 2015. "Effects of pharmaceutical cost containment policies on doctors’ prescribing behavior: Focus on antibiotics," Health Policy, Elsevier, vol. 119(9), pages 1245-1254.
    9. Laba, Tracey-Lea & Cheng, Lucy & Worthington, Heather C. & McGrail, Kimberlyn M. & Chan, Fiona K.I. & Mamdani, Muhammad & Law, Michael R., 2020. "What happens to drug use and expenditure when cost sharing is completely removed? Evidence from a Canadian provincial public drug plan," Health Policy, Elsevier, vol. 124(9), pages 977-983.
    10. Beatriz Gonzalez Lopez-Valcarcel & Jaume Puig-Junoy & Santiago Rodriguez Feijoó, 2016. "Copagos sanitarios. Revisión de experiencias internacionales y propuestas de diseño," Policy Papers 2016-04, FEDEA.

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