Social Inequalities and Pharmaceutical Cost Sharing in Italian Regions

Terraneo, Marco; Sarti, Simone; Bordogna, Mara Tognetti

doi:10.2190/hs.44.4.e

Cited by 12 publications

(7 citation statements)

References 19 publications

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“…Difficulty in paying the basic charge ("ticket") is a further gauge of the im-pact of the crisis on health: fewer services are prescribed or patients fail to go through with them [26] [27]. In Italy, the recourse to dental care has fallen off by 23.0% since 2012 [4].…”

Section: Discussionmentioning

confidence: 99%

Recourse to Complementary/Alternative Medicine (CAM) at Times of Economic Crisis: The Case of Italy

Bordogna¹

2017

JSS

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The economic crisis that has invested western countries in the last years has determined a significant reduction in consumption of medication and treatments recourse, too. The Economic recession is generally accompanied by a decrease in health-related consumption, varying according to the welfare model, and especially affecting people of working age with a low income. The present paper focuses on the effects of the economic crisis on users of Complementary/Alternative Medicine treatments (from now on referred as CAM). Based on multi-purpose data analyses, this work aims to examine what kind of strategies such consumers have adopted in order not to neglect their health despite feeling the economic pinch. Our analyses are principally based on ISTAT, Italian National Institute for Recording Statistics findings. Specifically, our research is based on the survey "Health conditions and recourse to health services". The analysed data refer to the Italian context in the period comprised from 2000 to 2013. The results of this work reveal how, in this delicate phase of the economy, traditional consumers of CAM have signally reduced their use of such treatments. In Italy, in the observed period, factors as working status, age, smoking and chronic diseases have been determinant in the decision to use CAM. The article suggests that, where health is at stake, CAM users are more strategic than the average biomedicine users. Furthermore, confirming the past trend, it shows how difficult it is to afford forms of treatment not covered by the health system as well as it underlines the lack of data for comparison with other countries.

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Section: Discussionmentioning

confidence: 99%

Recourse to Complementary/Alternative Medicine (CAM) at Times of Economic Crisis: The Case of Italy

Bordogna¹

2017

JSS

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“…19,20 In Italy, a country also hit by economic recession, a recent analysis suggests that changes in cost-sharing policies were partly successful, in terms of greater revenue to the health system, but in the last few years, cost-sharing increases would seem to have rebounded negatively on more vulnerable families, due to the economic crisis. 21 In Spain, where a set of cost-sharing reforms on pharmaceutical prescriptions with regional variants have been established since July 2012, in the context of heavy austerity reforms of public financing, a dramatic reduction in the use of drugs has already been noted. 22 Even in countries without serious financial problems, such as Sweden or Australia, large increases in cost-sharing impact on patients’ ability to afford essential drugs.…”

Section: Discussionmentioning

confidence: 99%

Cost-Sharing Rates Increase During Deep Recession: Preliminary Data From Greece

Gouvalas¹,

Igoumenidis

Θεοδώρου

et al. 2016

Int J Health Policy Manag

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Background: Measures taken over the past four years in Greece to reduce pharmaceutical expenditure have led to significant price reductions for medicines, but have also changed patient cost-sharing rates for prescription drugs. This study attempts to capture the resulting increase in patients’ out-of-pocket (OOP) expenses for prescription drugs during the 2011-2014 period. Methods: The authors conducted a retrospective review of financial data derived from 39 883 prescriptions, dispensed at three randomly chosen pharmacies located in Lamia, central Greece. Results: The study recorded an average contribution rate per prescription as follows: 11.28% for 2011 (95% CI: 10.76-11.80), 14.10% for 2012, 19.97% for 2013, and 29.08% for 2014. Correspondingly, the mean patient charge per prescription for 2011 was €6.58 (95% CI: 6.22-6.94), €8.28 for 2012, €8.35 for 2013, and €10.87 for 2014. During the 2011-2014 period, mean percentage rate of patient contribution increased by 157.75%, while average patient charge per prescription in current prices increased by 65.22%. The use of a newly introduced internal reference price (IRP) system increased the level of prescription charge at a rate of 2.41% for 2012 (100% surcharge on patients), 26.24% for 2013 (49.95% on patients and 50.04% on the appropriate health insurance funds), and 47.72% for 2014 (85.06% on patients and 14.94% on funds). Conclusion: Increased cost-sharing rates for prescription drugs can reduce public pharmaceutical expenditure, but international experience shows that rising OOP expenses can compromise patients’ ability to pay, particularly when it comes to chronic diseases and vulnerable populations. Various suggestions could be effective in refining the cost-sharing approach by giving greater consideration to chronic patients, and to the poor and elderly.

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“…Between November 2017 and December 2018, 1206 people bene ted from the SMF and 227 (18.8%) and 147 (12.2%) renewed the help once and twice, respectively. Almost 96% (1154) of bene ciaries had an assigned co-payment rate of 40% (corresponding to non-pensioners with annual incomes up to 18,000 €), 3.1% (37) had a co-payment rate of 10% and the rest had a co-payment rate of 50% or 60%. Table 1 compares the sociodemographic characteristics of bene ciaries of the NGO Pharmaceutical Bank in Catalonia and those of the general Catalan population.…”

Section: Characteristics Of Bene Ciariesmentioning

confidence: 99%

“…The cost of medicines has been systematically identi ed as a factor that limits adherence to medications, mainly for disadvantaged populations [2][3][4]. The failure to effectively use prescription medicines can lead to worse health status and higher costs to the healthcare system [5].…”

Section: Introductionmentioning

confidence: 99%

Who suffers from pharmaceutical poverty and what are their needs? Evidence from a Spanish region.

Rubio-Valera¹,

Marqués-Ercilla

Peñarrubia-María

et al. 2020

Preprint

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Background Pharmaceutical poverty occurs when a patient cannot afford the cost of prescribed medication and/or medical products. Non-profit organisations are covering the cost of medication to those patients in some contexts. The aim of the study was to describe the population of beneficiaries of the PB, a non-governmental organization which provides free of charge access to medicines, and their utilization pattern of medicines and healthcare products. Methods This was an observational study using PB beneficiary data collected between November 2017 and December 2018 in Catalonia. The Catalan Health Service provided information from the general population. A descriptive analysis of the beneficiaries’ characteristics was conducted and compared to general population. Results The beneficiaries (N = 1206) were mainly adults with a low level of education, unemployed, with functional disability and with ≥ 1 children. Compared with the general population, the beneficiaries were older, had a lower level of education, showed a higher prevalence of functional disability, were less likely to be Spanish, and more likely to be divorced and unemployed. The beneficiaries were polymedicated and most were using medication related to the nervous (79%), musculo-skeletal (68%) and cardiovascular system (56%) and alimentary tract and metabolism (68%). Almost 19% of beneficiaries used healthcare products. Female beneficiaries were older and more likely to be divorced or widowed, employed and with children. Compared to men, women were more likely to use medicines for pain and mental disorders. The paediatric group used medications for severe, chronic conditions (heart diseases, autoimmune diseases, conduct disorders and attention deficit hyperactivity disorder). Conclusions Patients with severe, chronic and disabling conditions are affected by pharmaceutical poverty. While the system of co-payment remains unchanged, physicians and paediatricians should explore economic barriers to treatment and direct their patients to resources that help to cover the cost of treatment.

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Social Inequalities and Pharmaceutical Cost Sharing in Italian Regions

Cited by 12 publications

References 19 publications

Recourse to Complementary/Alternative Medicine (CAM) at Times of Economic Crisis: The Case of Italy

Recourse to Complementary/Alternative Medicine (CAM) at Times of Economic Crisis: The Case of Italy

Cost-Sharing Rates Increase During Deep Recession: Preliminary Data From Greece

Who suffers from pharmaceutical poverty and what are their needs? Evidence from a Spanish region.

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