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Free Medicines Thanks to Retirement: Impact of Coinsurance Exemption on Pharmaceutical Expenditures and Hospitalization Offsets in a national health service

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  • Jaume Puig‐Junoy
  • Pilar García‐Gómez
  • David Casado‐Marín

Abstract

This paper examines the impact of coinsurance exemption for prescription medicines applied to elderly individuals in Spain after retirement. We use a rich administrative dataset that links pharmaceutical consumption and hospital discharge records for the full population aged 58 to 65 years in January 2004 covered by the public insurer in a Spanish region, and we follow them until December 2006. We use a difference‐in‐differences strategy and exploit the eligibility age for Social Security to control for the endogeneity of the retirement decision. Our results show that this uniform exemption increases the consumption of prescription medicines on average by 17.5%, total pharmaceutical expenditure by 25% and the costs borne by the insurer by 60.4%, without evidence of any offset effect in the form of lower short term probability of hospitalization. The impact is concentrated among consumers of medicines for acute and other non‐chronic diseases whose previous coinsurance rate was 30% to 40%. Copyright © 2015 John Wiley & Sons, Ltd.

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  • Jaume Puig‐Junoy & Pilar García‐Gómez & David Casado‐Marín, 2016. "Free Medicines Thanks to Retirement: Impact of Coinsurance Exemption on Pharmaceutical Expenditures and Hospitalization Offsets in a national health service," Health Economics, John Wiley & Sons, Ltd., vol. 25(6), pages 750-767, June.
    • Handle: RePEc:wly:hlthec:v:25:y:2016:i:6:p:750-767
    DOI: 10.1002/hec.3182
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    Cited by:

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    2. Américo, Pedro & Rocha, Rudi, 2020. "Subsidizing access to prescription drugs and health outcomes: The case of diabetes," Journal of Health Economics, Elsevier, vol. 72(C).
    3. Pilar García-Gómez & Toni Mora & Jaume Puig-Junoy, 2018. "Does €1 Per Prescription Make a Difference? Impact of a Capped Low-Intensity Pharmaceutical Co-Payment," Applied Health Economics and Health Policy, Springer, vol. 16(3), pages 407-414, June.
    4. Laia Maynou & Gabriel Coll-de-Tuero & Marc Saez, 2019. "The effects of copayment in primary health care: evidence from a natural experiment," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 20(8), pages 1237-1248, November.
    5. Yuanyuan Ma & Anne Nolan, 2017. "Public Healthcare Entitlements and Healthcare Utilisation among the Older Population in Ireland," Health Economics, John Wiley & Sons, Ltd., vol. 26(11), pages 1412-1428, November.
    6. Stijn Baert & Bas van der Klaauw & Gijsbert van Lomwel, 2018. "The effectiveness of medical and vocational interventions for reducing sick leave of self‐employed workers," Health Economics, John Wiley & Sons, Ltd., vol. 27(2), pages 139-152, February.
    7. Zhigang Guo & Lin Bai & Zhenhuan Luo & Mengyuan Fu & Liguang Zheng & Xiaodong Guan & Luwen Shi, 2021. "Factors Associated with Free Medicine Use in Patients with Hypertension and Diabetes: A 4-Year Longitudinal Study on Full Coverage Policy for Essential Medicines in Taizhou, China," IJERPH, MDPI, vol. 18(22), pages 1-10, November.
    8. Mario Martínez-Jiménez & Pilar García-Gómez & Jaume Puig-Junoy, 2021. "The Effect of Changes in Cost Sharing on the Consumption of Prescription and Over-the-Counter Medicines in Catalonia," IJERPH, MDPI, vol. 18(5), pages 1-21, March.

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