IDEAS home Printed from https://ideas.repec.org/a/wly/hlthec/v29y2020i12p1804-1812.html
   My bibliography  Save this article

Free prescriptions for low‐income pensioners? The cost of returning to free‐of‐charge drugs in the Spanish National Health Service

Author

Listed:
  • Jaume Puig‐Junoy
  • Jaime Pinilla

Abstract

This study estimated the impact of reducing a capped low coinsurance rate for outpatient medicines to nil for low‐income pensioners and disabled individuals in the Valencian Community (Spain). This reduction was implemented in January 2016 as a regional reform which modified the national cost‐sharing reform adopted in July 2012. The impact of this intervention on the number of monthly prescriptions dispensed between July 2012 and December 2018 was estimated using two different approaches of the synthetic control method, the classical method and the method based on Bayesian structural time series. The estimates from both methods were similar, showing significant overall increases of 6.34% and 6.70% [95% credible interval: 4.05, 9.47], respectively in the number of prescriptions dispensed in this region. These results are similar to those of the previous studies indicating that reducing price from a small amount to zero discontinuously boosts demand. This evidence indicates that the impact of this intervention on the budget of the regional health service is far greater than the amount of the subsidy in the public budget. These results are useful for making accurate budgetary projections for similar eliminations of charges for low‐income pensioners in the Spanish National Health Service.

Suggested Citation

  • Jaume Puig‐Junoy & Jaime Pinilla, 2020. "Free prescriptions for low‐income pensioners? The cost of returning to free‐of‐charge drugs in the Spanish National Health Service," Health Economics, John Wiley & Sons, Ltd., vol. 29(12), pages 1804-1812, December.
    • Handle: RePEc:wly:hlthec:v:29:y:2020:i:12:p:1804-1812
    DOI: 10.1002/hec.4161
    as

    Download full text from publisher

    File URL: https://doi.org/10.1002/hec.4161
    Download Restriction: no
    File URL: https://libkey.io/10.1002/hec.4161?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    References listed on IDEAS

    as
    1. Rieger, Matthias & Wagner, Natascha & Mebratie, Anagaw & Alemu, Getnet & Bedi, Arjun, 2019. "The impact of the Ethiopian health extension program and health development army on maternal mortality: A synthetic control approach," Social Science & Medicine, Elsevier, vol. 232(C), pages 374-381.
    2. Toshiaki Iizuka & Hitoshi Shigeoka, 2018. "Free for Children? Patient Cost-sharing and Healthcare Utilization," NBER Working Papers 25306, National Bureau of Economic Research, Inc.
    3. Alberto Abadie & Javier Gardeazabal, 2003. "The Economic Costs of Conflict: A Case Study of the Basque Country," American Economic Review, American Economic Association, vol. 93(1), pages 113-132, March.
    4. Charles J. Courtemanche & Daniela Zapata, 2014. "Does Universal Coverage Improve Health? The Massachusetts Experience," Journal of Policy Analysis and Management, John Wiley & Sons, Ltd., vol. 33(1), pages 36-69, January.
    5. Sebastian Galiani & Brian Quistorff, 2017. "The synth runner package: Utilities to automate synthetic control estimation using synth," Stata Journal, StataCorp LP, vol. 17(4), pages 834-849, December.
    6. Noémi Kreif & Richard Grieve & Dominik Hangartner & Alex James Turner & Silviya Nikolova & Matt Sutton, 2016. "Examination of the Synthetic Control Method for Evaluating Health Policies with Multiple Treated Units," Health Economics, John Wiley & Sons, Ltd., vol. 25(12), pages 1514-1528, December.
    7. Kristina Shampanier & Nina Mazar & Dan Ariely, 2007. "Zero as a Special Price: The True Value of Free Products," Marketing Science, INFORMS, vol. 26(6), pages 742-757, 11-12.
    8. Abadie, Alberto & Diamond, Alexis & Hainmueller, Jens, 2011. "Synth: An R Package for Synthetic Control Methods in Comparative Case Studies," Journal of Statistical Software, Foundation for Open Access Statistics, vol. 42(i13).
    9. Cristina Hernández-Izquierdo & Beatriz González López-Valcárcel & Stephen Morris & Mariya Melnychuk & Ignacio Abásolo Alessón, 2019. "The effect of a change in co-payment on prescription drug demand in a National Health System: The case of 15 drug families by price elasticity of demand," PLOS ONE, Public Library of Science, vol. 14(3), pages 1-39, March.
    10. Katherine Baicker & Sendhil Mullainathan & Joshua Schwartzstein, 2015. "Behavioral Hazard in Health Insurance," The Quarterly Journal of Economics, President and Fellows of Harvard College, vol. 130(4), pages 1623-1667.
    11. 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.
    12. Abadie, Alberto & Diamond, Alexis & Hainmueller, Jens, 2010. "Synthetic Control Methods for Comparative Case Studies: Estimating the Effect of California’s Tobacco Control Program," Journal of the American Statistical Association, American Statistical Association, vol. 105(490), pages 493-505.
    13. 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.
    Full references (including those not matched with items on IDEAS)

    Citations

    Blog mentions

    As found by EconAcademics.org, the blog aggregator for Economics research:
    1. Chris Sampson’s journal round-up for 7th December 2020
      by Chris Sampson in The Academic Health Economists' Blog on 2020-12-07 12:00:03

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Amos Z. B. Flomo & Elissaios Papyrakis & Natascha Wagner, 2023. "Evaluating the economic effects of the Ebola virus disease in Liberia: A synthetic control approach," Journal of International Development, John Wiley & Sons, Ltd., vol. 35(6), pages 1478-1504, August.
    2. Daniel Albalate & Germà Bel & Ferran A. Mazaira-Font, 2020. "Ensuring Stability, Accuracy and Meaningfulness in Synthetic Control Methods: The Regularized SHAP-Distance Method," IREA Working Papers 202005, University of Barcelona, Research Institute of Applied Economics, revised Apr 2020.
    3. Bruno Ferman & Cristine Pinto & Vitor Possebom, 2020. "Cherry Picking with Synthetic Controls," Journal of Policy Analysis and Management, John Wiley & Sons, Ltd., vol. 39(2), pages 510-532, March.
    4. Johanna Catherine Maclean & Brendan Saloner, 2018. "Substance Use Treatment Provider Behavior and Healthcare Reform: Evidence from Massachusetts," Health Economics, John Wiley & Sons, Ltd., vol. 27(1), pages 76-101, January.
    5. Alexander S. Skorobogatov, 2021. "The effect of alcohol sales restrictions on alcohol poisoning mortality: Evidence from Russia," Health Economics, John Wiley & Sons, Ltd., vol. 30(6), pages 1417-1442, June.
    6. Nicolas R. Ziebarth, 2018. "Social Insurance and Health," Contributions to Economic Analysis, in: Health Econometrics, volume 127, pages 57-84, Emerald Group Publishing Limited.
    7. Wu, Rongxin & Tan, Zhizhou & Lin, Boqiang, 2023. "Does carbon emission trading scheme really improve the CO2 emission efficiency? Evidence from China's iron and steel industry," Energy, Elsevier, vol. 277(C).
    8. Chu, Yu-Wei Luke & Townsend, Wilbur, 2019. "Joint culpability: The effects of medical marijuana laws on crime," Journal of Economic Behavior & Organization, Elsevier, vol. 159(C), pages 502-525.
    9. Alena Bachleitner, 2017. "Abolishing the Wealth Tax. A Case Study for Germany," WIFO Working Papers 545, WIFO.
    10. Brett Parker, 2021. "Death Penalty Statutes and Murder Rates: Evidence From Synthetic Controls," Journal of Empirical Legal Studies, John Wiley & Sons, vol. 18(3), pages 488-533, September.
    11. Gius, Mark, 2019. "Using the synthetic control method to determine the effects of concealed carry laws on state-level murder rates," International Review of Law and Economics, Elsevier, vol. 57(C), pages 1-11.
    12. McCloud, Nadine, 2022. "Does domestic investment respond to inflation targeting? A synthetic control investigation," International Economics, Elsevier, vol. 169(C), pages 98-134.
    13. Mitze, Timo & Kosfeld, Reinhold & Rode, Johannes & Wälde, Klaus, 2020. "Face Masks Considerably Reduce COVID-19 Cases in Germany: A Synthetic Control Method Approach," IZA Discussion Papers 13319, Institute of Labor Economics (IZA).
    14. Cummins Joseph & Miller Douglas L. & Smith Brock & Simon David, 2024. "Matching on Noise: Finite Sample Bias in the Synthetic Control Estimator," Journal of Econometric Methods, De Gruyter, vol. 13(1), pages 67-95, January.
    15. Christoph F. Kurz & Martin Rehm & Rolf Holle & Christina Teuner & Michael Laxy & Larissa Schwarzkopf, 2019. "The effect of bariatric surgery on health care costs: A synthetic control approach using Bayesian structural time series," Health Economics, John Wiley & Sons, Ltd., vol. 28(11), pages 1293-1307, November.
    16. Mark Gius, 2019. "Using the Synthetic Control Method to Determine the Effect of Ultrasound Laws on State-Level Abortion Rates," Atlantic Economic Journal, Springer;International Atlantic Economic Society, vol. 47(2), pages 205-215, June.
    17. Camilla Beck Olsen & Hans Olav Melberg, 2018. "Did adolescents in Norway respond to the elimination of copayments for general practitioner services?," Health Economics, John Wiley & Sons, Ltd., vol. 27(7), pages 1120-1130, July.
    18. Gius, Mark, 2020. "Examining the impact of child access prevention laws on youth firearm suicides using the synthetic control method," International Review of Law and Economics, Elsevier, vol. 63(C).
    19. David Gilchrist & Thomas Emery & Nuno Garoupa & Rok Spruk, 2023. "Synthetic Control Method: A tool for comparative case studies in economic history," Journal of Economic Surveys, Wiley Blackwell, vol. 37(2), pages 409-445, April.
    20. Kaul, Ashok & Klößner, Stefan & Pfeifer, Gregor & Schieler, Manuel, 2015. "Synthetic Control Methods: Never Use All Pre-Intervention Outcomes Together With Covariates," MPRA Paper 83790, University Library of Munich, Germany.

    More about this item

    Statistics

    Access and download statistics

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:wly:hlthec:v:29:y:2020:i:12:p:1804-1812. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: Wiley Content Delivery (email available below). General contact details of provider: http://www3.interscience.wiley.com/cgi-bin/jhome/5749 .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.