Impact of the 2012 pharmaceutical co-payment reform on drug consumption among children in Catalonia: Evidence from a regression discontinuity design

IF 3.4 3区医学 Q1 HEALTH CARE SCIENCES & SERVICES

Health Policy Pub Date : 2025-07-29 DOI:10.1016/j.healthpol.2025.105413

Toni Mora

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引用次数: 0

Abstract

Background

Poor childhood health negatively affects health and socioeconomic status later in life. One crucial policy tool is the modification of co-payment conditions, which can cause parents to experience more rigid budget constraints and cause reductions in the number of prescription drugs given to their children.

Objective

This study estimates the price sensitivity of prescription drug demand using data on all prescription drug purchases for the non-adult population in Catalonia from 2010 to 2015.

Methods

We use a sharp regression discontinuity design (RDD) with no bandwidth, exploiting 2012 reforms in Catalonia (Spain).

Results

Our results indicate overall reductions in the defined daily dose (DDD) consumption over three years post-reform for children of parents who experienced increases in their co-payment levels (8.1 % for a 10 % increase). In contrast, those whose parents did not experience a reduction in co-payment rates had a 7.0 percentage point increase in the number of prescriptions used. We corroborated our findings by considering drug stockpiling. Interestingly, prescriptions related to females showed higher reductions than those for males. Disentangling drug consumption by type of condition, we show that drug purchases related to respiratory health conditions experienced smaller reductions and, more specifically, the ones associated with asthma, compared to mental health diseases such as Attention-Deficit/Hyperactivity Disorder.

Conclusions

We evidence significant changes in overall drug consumption for young people in Spain following the reforms of co-payments.

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2012年药品共同支付改革对加泰罗尼亚儿童药品消费的影响：来自回归不连续设计的证据

儿童时期健康状况不佳会对以后的健康和社会经济地位产生负面影响。一个关键的政策工具是修改共同支付条件，这可能导致父母经历更严格的预算限制，并导致给孩子的处方药数量减少。目的利用2010 - 2015年加泰罗尼亚地区非成年人口处方药购买数据，对处方药需求的价格敏感性进行估算。方法采用无带宽的锐回归不连续设计（RDD），以2012年西班牙加泰罗尼亚地区的改革为研究对象。结果我们的研究结果表明，在改革后的三年内，共同支付水平增加的父母的子女的限定日剂量（DDD）消费量总体下降（增加10%的父母的DDD消费量下降8.1%）。相比之下，那些父母没有经历共同支付率减少的孩子，他们使用的处方数量增加了7.0个百分点。我们通过考虑药物储存来证实我们的发现。有趣的是，与女性相关的处方显示出比男性更高的减少。通过对药物消费类型的分析，我们发现，与精神疾病（如注意力缺陷/多动障碍）相比，与呼吸系统健康状况相关的药物购买减少幅度较小，更具体地说，与哮喘相关的药物购买减少幅度较小。结论我们证明了西班牙共同支付改革后年轻人总体药物消费的显著变化。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Health Policy 医学-卫生保健

CiteScore

6.40

自引率

6.10%

发文量

157

审稿时长

3-8 weeks

期刊介绍： Health Policy is intended to be a vehicle for the exploration and discussion of health policy and health system issues and is aimed in particular at enhancing communication between health policy and system researchers, legislators, decision-makers and professionals concerned with developing, implementing, and analysing health policy, health systems and health care reforms, primarily in high-income countries outside the U.S.A.