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

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 ۲۰۱۱-۲۰۱۴ period.   Methods The authors conducted a retrospective review of financial data derived from ۳۹ ۸۸۳ prescriptions, dispensed at three randomly chosen pharmacies located in Lamia, central Greece.   Results The study recorded an average contribution rate per prescription as follows: ۱۱.۲۸% for ۲۰۱۱ (۹۵% CI: ۱۰.۷۶-۱۱.۸۰), ۱۴.۱۰% for ۲۰۱۲, ۱۹.۹۷% for ۲۰۱۳, and ۲۹.۰۸% for ۲۰۱۴. Correspondingly, the mean patient charge per prescription for ۲۰۱۱ was €۶.۵۸ (۹۵% CI: ۶.۲۲-۶.۹۴), €۸.۲۸ for ۲۰۱۲, €۸.۳۵ for ۲۰۱۳, and €۱۰.۸۷ for ۲۰۱۴. During the ۲۰۱۱-۲۰۱۴ period, mean percentage rate of patient contribution increased by ۱۵۷.۷۵%, while average patient charge per prescription in current prices increased by ۶۵.۲۲%. The use of a newly introduced internal reference price (IRP) system increased the level of prescription charge at a rate of ۲.۴۱% for ۲۰۱۲ (۱۰۰% surcharge on patients), ۲۶.۲۴% for ۲۰۱۳ (۴۹.۹۵% on patients and ۵۰.۰۴% on the appropriate health insurance funds), and ۴۷.۷۲% for ۲۰۱۴ (۸۵.۰۶% on patients and ۱۴.۹۴% 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 costsharing approach by giving greater consideration to chronic patients, and to the poor and elderly.

کلیدواژه ها:

Cost-Sharing ، Patient Participation ، Prescription Drugs ، Out-of-Pocket (OOP) Expenses