Cost sharing of prescription drugs and demand for health-care utilization among seniors with rheumatoid arthritis

Abstract

We employed a pre–post study design with a control group – a Difference-In-Difference (DID) estimator – to evaluate the effect of prescription drug policy reform on the number of prescriptions filled, the number of physician visits, the likelihood of hospitalizations and the number of hospitalizations among seniors with Rheumatoid Arthritis (RA) in British Columbia (BC), Canada. Our study demonstrates that when patients have to pay part of all of their drug costs, they often have more doctor visits and hospitalization events. Our results show that in a predominantly publicly funded health-care system, piecewise introduction of market-driven cost containment concepts such as patient cost sharing might have the unintended impact of increasing overall health utilization.

Keywords:

• cost sharing
• health-care utilization
• difference-in-difference estimator
• rheumatoid arthritis

JEL Classification:

• I18
• I10

Acknowledgements

The authors are grateful to Daphne Guh, Huiying Sun and Nick Bansback for valuable comments, and to Diane Lacaille and John Esdaile for being involved in the earlier phase of the study and data access.