Vertaisarvioitu alkuperäisartikkeli tai data-artikkeli tieteellisessä aikakauslehdessä (A1)
The impact of a co-payment increase on the consumption of type 2 antidiabetics – A nationwide interrupted time series analysis
Julkaisun tekijät: Hanna Rättö, Terhi Kurko, Jaana E. Martikainen, Katri Aaltonen
Kustantaja: Elsevier B.V.
Paikka: Amsterdam
Julkaisuvuosi: 2021
Journal: Health Policy
eISSN: 0168-8510
DOI: http://dx.doi.org/10.1016/j.healthpol.2021.05.007
Verkko-osoite: https://www.sciencedirect.com/science/article/pii/S0168851021001342
Rinnakkaistallenteen osoite: https://research.utu.fi/converis/portal/Publication/57350674
International literature suggests
that co-payment increases are associated with decreased medicine use,
although the effects depend on context. We examined the impact of a
co-payment increase on the consumption of type 2 antidiabetics in
Finland, a country with a comprehensive health and social security
system including ceiling mechanisms aiming to protect patients from high
co-payment expenditures.
We used administrative
register data on all reimbursed purchases of antidiabetics during
2014−2018. An interrupted time series design with segmented regression
was used to examine the mean monthly purchase per person, measured as
Defined Daily Doses (DDDs), before and after the co-payment increase.
At baseline, the mean monthly purchase per person of type 2 antidiabetics was 105 DDDs (95% CI 103.8; 106.0;p<0.001) and there was a decreasing trend of 0.2 DDDs per month (95% CI -0.23;-0.13;p<0.001). A statistically significant decrease of 5.6 DDDs (95% CI -7.3;-3.8;p<0.001)
was detected after the reform; however, no significant change in the
trend was observed. No significant increase was detected in the mean
monthly per person purchase of insulins.
The results
suggest that a co-payment increase decreases consumption of necessary
medicines despite the presence of a medicine co-payment ceiling
mechanism. Whether the decrease was associated with negative health
effects remains to be further investigated.
Ladattava julkaisu This is an electronic reprint of the original article. |