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Co-payments and the demand for pharmaceuticals: Evidence from Italy

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Listed author(s):
  • Fiorio, Carlo V.
  • Siciliani, Luigi

Abstract

This study exploits a natural experiment in Italy to estimate how the demand for pharmaceuticals responds to variations in co-payment levels. After a period where co-payments were set to zero by a national law, the decision over co-payments was devolved to the Italian regions. While some regions re-introduced the co-payment, others did not. Using a difference-in-difference approach on regional monthly data for years 2001 and 2003, we find that an increase in the co-payment by one Euro reduces the per capita number of prescriptions by 4% and per capita public pharmaceutical expenditure by 3.4%. We also find evidence that when in 2006 some regions reduced (but not removed) the co-payment, a reduction in the co-payment by one Euro increased the per capita number of prescriptions by 3.4%, and per capita public pharmaceutical expenditure by 4.9%.

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File URL: http://www.sciencedirect.com/science/article/pii/S0264-9993(09)00131-X
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Article provided by Elsevier in its journal Economic Modelling.

Volume (Year): 27 (2010)
Issue (Month): 4 (July)
Pages: 835-841

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Handle: RePEc:eee:ecmode:v:27:y:2010:i:4:p:835-841
Contact details of provider: Web page: http://www.elsevier.com/locate/inca/30411

Keywords: Prescriptions Pharmaceutical expenditure Co-payments Moral hazard;

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  1. Atella, Vincenzo, 2000. "Drug cost containment policies in Italy: are they really effective in the long-run?: The case of minimum reference price," Health Policy, Elsevier, vol. 50(3), pages 197-218, January.
  2. Chalkley, Martin & Malcomson, James M., 1998. "Contracting for health services when patient demand does not reflect quality," Journal of Health Economics, Elsevier, vol. 17(1), pages 1-19, January.
  3. Brekke, Kurt R. & Konigbauer, Ingrid & Straume, Odd Rune, 2007. "Reference pricing of pharmaceuticals," Journal of Health Economics, Elsevier, vol. 26(3), pages 613-642, May.
  4. Okunade, Albert A. & Suraratdecha, Chutima, 2006. "The pervasiveness of pharmaceutical expenditure inertia in the OECD countries," Social Science & Medicine, Elsevier, vol. 63(1), pages 225-238, July.
  5. Gravelle, Hugh & Siciliani, Luigi, 2008. "Optimal quality, waits and charges in health insurance," Journal of Health Economics, Elsevier, vol. 27(3), pages 663-674, May.
  6. Tomas J. Philipson & Dana Goldman, 2007. "Integrated Insurance Design in the Presence of Multiple Medical Technologies," American Economic Review, American Economic Association, vol. 97(2), pages 427-432, May.
  7. Paul Grootendorst & David Stewart, 2006. "A re-examination of the impact of reference pricing on anti-hypertensive drug plan expenditures in British Columbia," Health Economics, John Wiley & Sons, Ltd., vol. 15(7), pages 735-742.
  8. DiMasi, Joseph A. & Hansen, Ronald W. & Grabowski, Henry G. & Lasagna, Louis, 1991. "Cost of innovation in the pharmaceutical industry," Journal of Health Economics, Elsevier, vol. 10(2), pages 107-142, July.
  9. Paul Contoyannis & Jeremiah Hurley & Paul Grootendorst & Sung-Hee Jeon & Robyn Tamblyn, 2005. "Estimating the price elasticity of expenditure for prescription drugs in the presence of non-linear price schedules: an illustration from Quebec, Canada," Health Economics, John Wiley & Sons, Ltd., vol. 14(9), pages 909-923.
  10. Vincenzo Atella & Franco Peracchi & Domenico Depalo & Claudio Rossetti, 2006. "Drug compliance, co-payment and health outcomes: evidence from a panel of Italian patients," Health Economics, John Wiley & Sons, Ltd., vol. 15(9), pages 875-892.
  11. Leibowitz, Arleen & Manning, Willard G. & Newhouse, Joseph P., 1985. "The demand for prescription drugs as a function of cost-sharing," Social Science & Medicine, Elsevier, vol. 21(10), pages 1063-1069, January.
  12. Ryan, Mandy & Birch, Stephen, 1991. "Charging for health care: Evidence on the utilisation of NHS prescribed drugs," Social Science & Medicine, Elsevier, vol. 33(6), pages 681-687, January.
  13. Ellis, Randall P. & McGuire, Thomas G., 1986. "Provider behavior under prospective reimbursement : Cost sharing and supply," Journal of Health Economics, Elsevier, vol. 5(2), pages 129-151, June.
  14. Chiara Bonassi & Laura Magazzini & Fabio Pammolli & Massimo Riccaboni & Nicola Carmine Salerno, 2007. "La spesa farmaceutica territoriale convenzionata: il modello FarmaRegio per l'analisi della variabilità regionale," Working Papers CERM 03-2007, Competitività Regole Mercati (CERM).
  15. Cameron,A. Colin & Trivedi,Pravin K., 2005. "Microeconometrics," Cambridge Books, Cambridge University Press, number 9780521848053, February.
  16. O'Brien, Bernie, 1989. "The effect of patient charges on the utilisation of prescription medicines," Journal of Health Economics, Elsevier, vol. 8(1), pages 109-132, March.
  17. Street, Andrew & Jones, Andrew & Furuta, Aya, 1999. "Cost-sharing and pharmaceutical utilisation and expenditure in Russia," Journal of Health Economics, Elsevier, vol. 18(4), pages 459-472, August.
  18. Jesús Clemente & Carmen Marcuello & Antonio Montañés, 2008. "Pharmaceutical expenditure, total health-care expenditure and GDP," Health Economics, John Wiley & Sons, Ltd., vol. 17(10), pages 1187-1206.
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Cited by:

  1. Patrizio Armeni & Claudio Jommi & Monica Otto, 2016. "The simultaneous effects of pharmaceutical policies from payers’ and patients’ perspectives: Italy as a case study," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 17(8), pages 963-977, November.
  2. Astrid Kiil & Kurt Houlberg, 2014. "How does copayment for health care services affect demand, health and redistribution? A systematic review of the empirical evidence from 1990 to 2011," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 15(8), pages 813-828, November.
  3. Livio Garattini & Katelijne Vooren, 2013. "Could co-payments on drugs help to make EU health care systems less open to political influence?," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 14(5), pages 709-713, October.
  4. M. Filippini & G. Masiero, 2012. "An empirical analysis of habit and addiction to antibiotics," Empirical Economics, Springer, vol. 42(2), pages 471-486, April.
  5. Laura González & Giuliano Masiero, 2011. "Disentangling spillover effects of antibiotic consumption: a spatial panel approach," Quaderni della facoltà di Scienze economiche dell'Università di Lugano 1106, USI Università della Svizzera italiana.

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