TY - JOUR
T1 - Trends and income related differences in out-of-pocket costs for prescription and over-the-counter medicines in Finland from 1985 to 2006
AU - Aaltonen, Katri
AU - Niemela, Mikko
AU - Norris, Pauline
AU - Bell, John Simon Frederick
AU - Hartikainen, Sirpa
PY - 2013
Y1 - 2013
N2 - Objective: To explore trends and income related differences in out-of-pocket (OOP) costs for prescription and over-the-counter medicines in Finland in 1985-2006.
Methods: Cross-sectional data collected in Household Budget Surveys conducted in 1985, 1990, 1995, 2001 and 2006 were used to calculate trends in household OOP payments in absolute and relative terms. Covariance analyses were used to evaluate age-adjusted OOP costs across income groups.
Results: Mean OOP costs per household increased 2.7 fold over inflation from 1985 to 2006. The growth was steepest (60 ) in 1990-1995 and slowest (10 ) in 1995-2001. The mean costs, in 2006 currency value, increased from (sic) 138 to (sic) 373 and the average share of household total consumption spent on medicines increased from 0.8 to 1.6 . After adjusting by age, the lowest income quintile had the lowest mean OOP costs for all types of medicines at every time point, although the overall differences were small. In 1985/2006, the age-adjusted estimated marginal means for household medicinal costs were (sic) 121/(sic) 332 for the lowest income quintile and (sic) 138/(sic) 449 for the highest quintile, and for the share of household consumption 1.1 /2.2 for the lowest and 0.5 /1.1 for the highest quintile.
Conclusions: All patients faced increasing OOP payments for medicines throughout the study period, but the relative growth was largest for the lowest income groups. Our results suggest that savings achieved by increasing the patients share of costs coincided with steep growth in OOP costs and wider differences between income groups. Cost containment measures targeted at prices, on the other hand, coincided with stabilised OOP costs and decreasing dispersion between the income quintiles. More research is needed to evaluate whether differences in OOP costs reflect differences in patterns of use. (C) 2013 Elsevier Ireland Ltd. All rights reserved.
AB - Objective: To explore trends and income related differences in out-of-pocket (OOP) costs for prescription and over-the-counter medicines in Finland in 1985-2006.
Methods: Cross-sectional data collected in Household Budget Surveys conducted in 1985, 1990, 1995, 2001 and 2006 were used to calculate trends in household OOP payments in absolute and relative terms. Covariance analyses were used to evaluate age-adjusted OOP costs across income groups.
Results: Mean OOP costs per household increased 2.7 fold over inflation from 1985 to 2006. The growth was steepest (60 ) in 1990-1995 and slowest (10 ) in 1995-2001. The mean costs, in 2006 currency value, increased from (sic) 138 to (sic) 373 and the average share of household total consumption spent on medicines increased from 0.8 to 1.6 . After adjusting by age, the lowest income quintile had the lowest mean OOP costs for all types of medicines at every time point, although the overall differences were small. In 1985/2006, the age-adjusted estimated marginal means for household medicinal costs were (sic) 121/(sic) 332 for the lowest income quintile and (sic) 138/(sic) 449 for the highest quintile, and for the share of household consumption 1.1 /2.2 for the lowest and 0.5 /1.1 for the highest quintile.
Conclusions: All patients faced increasing OOP payments for medicines throughout the study period, but the relative growth was largest for the lowest income groups. Our results suggest that savings achieved by increasing the patients share of costs coincided with steep growth in OOP costs and wider differences between income groups. Cost containment measures targeted at prices, on the other hand, coincided with stabilised OOP costs and decreasing dispersion between the income quintiles. More research is needed to evaluate whether differences in OOP costs reflect differences in patterns of use. (C) 2013 Elsevier Ireland Ltd. All rights reserved.
UR - http://www.sciencedirect.com.ezproxy.lib.monash.edu.au/science/article/pii/S0168851012003314
U2 - 10.1016/j.healthpol.2012.12.004
DO - 10.1016/j.healthpol.2012.12.004
M3 - Article
SN - 0168-8510
VL - 110
SP - 131
EP - 140
JO - Health Policy
JF - Health Policy
IS - 2-3
ER -