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

Abstract

Full coverage policies for medicines have been implemented worldwide to alleviate medicine cost burden and promote access to medicines. However, few studies have explored the factors associated with free medicine use in patients with chronic diseases. This study aimed to analyze the utilization of free medicines by patients with hypertension and diabetes after the implementation of the full coverage policy for essential medicines (FCPEM) in Taizhou, China, and to explore the factors associated with free medicine use. We conducted a descriptive analysis of characteristics of patients with and without free medicine use and performed a panel logit model to examine factors associated with free medicine use, based on an electronic health record database in Taizhou from the baseline year (12 months in priori) to three years after FCPEM implementation. After FCPEM implementation, the proportion of patients without any free medicine use decreased from 31.1% in the baseline year to 28.9% in the third year, while that of patients taking free medicines rose from 11.0% to 22.8%. Patients with lower income or education level, those with agricultural hukou, patients aged 65 and above, married patients, and patients in the Huangyan district were more likely to take free medicines. In conclusion, FCPEM contributed to improved medicine access, especially in vulnerable populations. Local policy makers should consider expanding the coverage of FCPEM to other types of medicines and cultivate the potential of social supports for patients to enhance the effectiveness of FCPEM policies.

Procurement of medicines to treat cancer, 2015–2020, China

“…Full coverage for both inpatients and outpatients has been adopted for medicines used to treat hypertension and diabetes in some pilot cities and has proved effective in reducing costs and promoting medicine use. 44 Full coverage for essential anti-cancer medicines may promote their use and reduce demand for expensive targeted medicines, especially when the two therapies lead to similar clinical benefits. Providing organized free screening services for high-risk populations and cancers can reduce the cancer burden 45 and the demand for anti-cancer medicines.…”

Effect of the full coverage policy of essential medicines on medication adherence: A quasi-experimental study in Taizhou, China

“…To promote adherence to medicines and control of chronic disease, at the end of 2011, Taizhou city required all the nine districts and counties within its jurisdiction to establish a catalog between 2012 and 2013, specifying which hypertension and diabetes medicines are listed in China's National Essential Medicines List (version 2012) were to reimburse in full ( 27 , 28 ). In June 2012, Huangyan was the first district in Taizhou to announce its reimbursement list of hypoglycaemic (metformin hydrochloride and glipizide tablets) and antihypertensive medicines (captopril and indapamide tablets), and all districts implemented their respective FCPEM policies in October 2013.…”