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Ageing, chronic conditions and the evolution of future drugs expenditure: a five-year micro-simulation from 2004 to 2029

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  • S. P. Thiébaut
  • T. Barnay
  • B. Ventelou

Abstract

The healthy ageing assumptions may lead to substantial changes in paths of aggregate health care expenditure, notably catastrophic expenditure of people at the end of the life. But clear assessments of involved amounts are not available when we specifically consider ambulatory care (as drug expenditure) generally offered to chronically-ill people. We estimate the effects of epidemiological and life expectancy changes on French health expenditure until 2029 by applying a Markovian micro-simulation model from a nationally representative database. The originality of these simulations holds in using an aggregate indicator of morbidity--mortality, capturing vital risk and making it possible to adapt the quantification of life expectancies by taking into account the presence of severe chronic pathologies. We forecast future national drugs expenditure, under different epidemiological scenarios of chronic morbidity: trend scenario, healthy ageing scenario and medical progress scenario . For the population aged 25+, results predict an increase in reimbursable drug expenditure of between 1.1% and 1.8% (annual growth rate), attributable solely to the ageing population and changes in health status.

Suggested Citation

  • S. P. Thiébaut & T. Barnay & B. Ventelou, 2013. "Ageing, chronic conditions and the evolution of future drugs expenditure: a five-year micro-simulation from 2004 to 2029," Applied Economics, Taylor & Francis Journals, vol. 45(13), pages 1663-1672, May.
  • Handle: RePEc:taf:applec:45:y:2013:i:13:p:1663-1672
    DOI: 10.1080/00036846.2011.633895
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    References listed on IDEAS

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    1. Meena Seshamani & Alastair Gray, 2004. "Ageing and health-care expenditure: the red herring argument revisited," Health Economics, John Wiley & Sons, Ltd., vol. 13(4), pages 303-314.
    2. Brigitte Dormont & Michel Grignon & Hélène Huber, 2006. "Health expenditure growth: reassessing the threat of ageing," Health Economics, John Wiley & Sons, Ltd., vol. 15(9), pages 947-963.
    3. Jean-Pierre Michel & Jean-Marie Robine, 2004. "A “New” General Theory of Population Ageing," The Geneva Papers on Risk and Insurance - Issues and Practice, Palgrave Macmillan;The Geneva Association, vol. 29(4), pages 667-678, October.
    4. Sally C. Stearns & Edward C. Norton, 2004. "Time to include time to death? The future of health care expenditure predictions," Health Economics, John Wiley & Sons, Ltd., vol. 13(4), pages 315-327.
    5. Jean-Pierre Michel & Jean-Marie Robine, 2004. "A "New" General Theory of Population Ageing," The Geneva Papers on Risk and Insurance, The International Association for the Study of Insurance Economics, vol. 29(4), pages 667-678, October.
    6. repec:dau:papers:123456789/3881 is not listed on IDEAS
    7. Peter Zweifel & Stefan Felder & Markus Meiers, 1999. "Ageing of population and health care expenditure: a red herring?," Health Economics, John Wiley & Sons, Ltd., vol. 8(6), pages 485-496.
    8. Manning, Willard G. & Mullahy, John, 2001. "Estimating log models: to transform or not to transform?," Journal of Health Economics, Elsevier, vol. 20(4), pages 461-494, July.
    9. Baoping Shang & Dana Goldman, 2008. "Does age or life expectancy better predict health care expenditures?," Health Economics, John Wiley & Sons, Ltd., vol. 17(4), pages 487-501.
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    Cited by:

    1. Charlotte Geay & Grégoire de Lagasnerie & Makram Larguem, 2015. "Intégrer les dépenses de santé dans un modèle de microsimulation dynamique : le cas des dépenses de soins de ville," Économie et Statistique, Programme National Persée, vol. 481(1), pages 211-234.
    2. Renuga Nagarajan & Aurora A.C. Teixeira & Sandra T. Silva, 2013. "The impact of population ageing on economic growth: an in-depth bibliometric analysis," FEP Working Papers 505, Universidade do Porto, Faculdade de Economia do Porto.
    3. Phill O’Neill & Jorge Mestre-Ferrandiz & Ruth Puig-Peiro & Jon Sussex, 2013. "Projecting Expenditure on Medicines in the UK NHS," PharmacoEconomics, Springer, vol. 31(10), pages 933-957, October.
    4. repec:wsi:serxxx:v:62:y:2017:i:02:n:s021759081550068x is not listed on IDEAS

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