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Impact of the phased abolition of co‐payments on the utilisation of selected prescription medicines in Wales
Author(s) -
Alam M. Fasihul,
Cohen David,
Dunstan Frank,
Hughes Dyfrig,
Routledge Philip
Publication year - 2018
Publication title -
health economics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.55
H-Index - 109
eISSN - 1099-1050
pISSN - 1057-9230
DOI - 10.1002/hec.3530
Subject(s) - medical prescription , payment , welsh , medicine , demography , natural experiment , population , significant difference , general practice , family medicine , demographic economics , business , geography , environmental health , economics , finance , nursing , archaeology , pathology , sociology
We have taken advantage of a natural experiment to measure the impact of the phased abolition of prescription co‐payments in Wales. We investigated 3 study periods covering the phased abolition: from £6 to £4, £4 to £3, and £3 to £0. A difference‐in‐difference modelling was adopted and applied to monthly UK general practice level dispensing data on 14 selected medicines which had the highest percentage of items dispensed subject to a co‐payment prior to abolition. Dispensing from a comparator region (North East of England) with similar health and socio‐economic characteristics to Wales, and where prescription co‐payments continued during the study periods, was used to isolate any non‐price effects on dispensing in Wales. Results show a small increase in dispensing of 14 selected medicines versus the comparator. Compared with NE England, monthly average Welsh dispensing was increased by 11.93 items (7.67%; 95% CI [7.2%, 8.1%]), 6.37 items (3.38%; 95% CI [2.9%, 3.7%]) and 9.18 items (4.54%; 95% CI [4.2%, 4.9%]) per practice per 1,000 population during the periods when co‐payment was reduced. Price elasticities of the selected medicines utilisation were −0.23, −0.13, and −0.04 in 3 analyses, suggesting the abolition of co‐payment had small effect on Welsh dispensing.