Role of Cost on Failure to Access Prescribed Pharmaceuticals: The Case of Statins

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dc.contributor.authorMcRae, Ian
dc.contributor.authorGool, Kees van
dc.contributor.authorHall, Jane
dc.contributor.authorYen, Laurann
dc.date.accessioned2021-09-13T23:53:05Z
dc.date.issued2017
dc.date.updated2020-11-23T11:04:48Z
dc.description.abstractBackground: In Australia, as in many other Western countries, patient surveys suggest the costs of medicines lead to deferring or avoiding filling of prescriptions. The Australian Pharmaceutical Benefits Scheme provides approved prescription medicines at subsidised prices with relatively low patient co-payments. The Pharmaceutical Benefits Scheme defines patient co-payment levels per script depending on whether patients are “concessional” (holding prescribed pension or other government concession cards) or “general”, and whether they have reached a safety net defined by total out-of-pocket costs for Pharmaceutical Benefits Scheme-approved medicines. Objective: The purpose of this study was to explore the impact of costs on adherence to statins in this relatively low-cost environment. Methods: Using data from a large-scale survey of older Australians in the state of New South Wales linked to administrative data from the national medical and pharmaceutical insurance schemes, we explore the relationships between adherence to medication regimes for statins and out-of-pocket costs of prescribed pharmaceuticals, income, other health costs, and a wide set of demographic and socio-economic control variables using both descriptive analysis and logistic regressions. Results: Within the general non-safety net group, which has the highest co-payment, those with lowest income have the lowest adherence, suggesting that the general safety threshold may be set at a level that forms a major barrier to statin adherence. This is reinforced by over 75% of those who were not adherent before reaching the safety net threshold becoming adherent after reaching the safety net with its lower co-payments. Conclusion: The main financial determinant of adherence is the concessional/general and safety net category of the patient, which means the main determinant is the level of co-payment.en_AU
dc.description.sponsorshipThe research was funded by the Research in the Finance and Economics of Primary Health Care Centre of Research Excellence (ReFinE-PHC) under the Australian Primary Health Care Research Institute’s Centres of Research Excellence funding scheme, which is supported by a grant from the Australian Government Department of Health.en_AU
dc.format.mimetypeapplication/pdfen_AU
dc.identifier.issn1175-5652en_AU
dc.identifier.urihttp://hdl.handle.net/1885/247836
dc.language.isoen_AUen_AU
dc.publisherOpen Mind Journalsen_AU
dc.rights© Springer International Publishing AG 2017en_AU
dc.sourceApplied Health Economics and Health Policyen_AU
dc.titleRole of Cost on Failure to Access Prescribed Pharmaceuticals: The Case of Statinsen_AU
dc.typeJournal articleen_AU
local.bibliographicCitation.issue5en_AU
local.bibliographicCitation.lastpage634en_AU
local.bibliographicCitation.startpage625en_AU
local.contributor.affiliationMcRae, Ian, College of Health and Medicine, ANUen_AU
local.contributor.affiliationGool, Kees van, Centre for Health Economics Research and Evaluation University of Technology Sydneyen_AU
local.contributor.affiliationHall, Jane, University of Technology Sydneyen_AU
local.contributor.affiliationYen, Laurann, College of Health and Medicine, ANUen_AU
local.contributor.authoremailu1589783@anu.edu.auen_AU
local.contributor.authoruidMcRae, Ian, u1589783en_AU
local.contributor.authoruidYen, Laurann, u4233387en_AU
local.description.embargo2099-12-31
local.description.notesImported from ARIESen_AU
local.identifier.absfor110399 - Clinical Sciences not elsewhere classifieden_AU
local.identifier.absseo920204 - Evaluation of Health Outcomesen_AU
local.identifier.ariespublicationa383154xPUB7505en_AU
local.identifier.citationvolume15en_AU
local.identifier.doi10.1007/s40258-017-0336-8en_AU
local.identifier.scopusID2-s2.0-85025157512
local.identifier.thomsonIDMEDLINE:28660496
local.identifier.uidSubmittedBya383154en_AU
local.publisher.urlhttps://link.springer.com/en_AU
local.type.statusPublished Versionen_AU

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