Pharmaceutical cost-sharing systems and savings for healthcare systems from parallel trade

In this paper we argue that Australia?s pharmaceutical cost sharing policy has been applied as if cost sharing is unproblematic for medicine affordability and good health outcomes. Australian and international experience with pharmaceutical cost sharing strongly suggests a negative impact on affordability and quality use of medicines, disproportionately affecting low income patients. We argue that Australia?s use of cost sharing reflects the currency of a cognitively powerful and morally charged idea ? moral hazard. Moral hazard refers to the change in behaviour induced by insurance coverage. Applied to pharmaceuticals, this means that low out-of-pocket cost will lead to waste. Moral hazard mixes the explanatory power of price with the intuitively cogent notion that if people do not experience consequences they will behave irresponsibly. Cost sharing policy has gone unscrutinised and uncontested not because cost sharing is unproblematic, but because in the light of the idea of moral hazard it has all the question-deadening weight of common sense.

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Regulating Patients’ Access to Healthcare Services

International Journal of Public and Private Healthcare Management and Economics ◽

10.4018/ijpphme.2011040101 ◽

2011 ◽

Vol 1 (2) ◽

pp. 1-16 ◽

Cited By ~ 8

Author(s):

Nadine Reibling ◽

Claus Wendt

Keyword(s):

Cost Sharing ◽

Free Choice ◽

Healthcare Services ◽

Healthcare Systems ◽

Income Levels ◽

Income Groups ◽

Health Aging ◽

Access Regulation ◽

Using Data ◽

Different Levels

Although some healthcare systems have introduced gatekeeping that forces patients to choose a general practitioner for a longer period, other systems rely on a free choice of doctors. This paper analyzes how these instruments affect differences in healthcare utilization in European countries. Using data from the first wave of the Survey of Health, Aging and Retirement, the authors investigate how access regulations affect a) the overall level of ambulatory healthcare usage, and b) disparities in utilization among groups with different educational and income levels. The data show that access regulation affects patients’ decisions to see a doctor and reduces the extent of specialist healthcare used. Cost sharing could not be related to inequities among income groups; however, gatekeeping has favorable effects on reducing inequality, and the respective healthcare systems show lower levels of inequality among groups with different levels of education.

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Determinants of Change in Medicaid Pharmaceutical Cost Sharing: Does Evidence Affect Policy?

Milbank Quarterly ◽

10.1111/1468-0009.00043 ◽

1997 ◽

Vol 75 (1) ◽

pp. 11-34 ◽

Cited By ~ 14

Author(s):

Stephen B. Soumerai ◽

Dennis Ross‐Degnan ◽

Eric E. Fortess ◽

Bryan L. Walser

Keyword(s):

Cost Sharing ◽

Pharmaceutical Cost

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The effect of cost sharing on the quality of dental care

Journal of Dental Education ◽

10.1002/j.0022-0337.1984.48.11.tb01837.x ◽

1984 ◽

Vol 48 (11) ◽

pp. 597-605 ◽

Cited By ~ 2

Author(s):

HL Bailit ◽

RH Brook ◽

CJ Kamberg ◽

GA Goldberg ◽

V Spolsky ◽

...

Keyword(s):

Dental Care ◽

Cost Sharing

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Toward Identifying Mild Cognitive Impairment in Hispanic and African American Adults

Perspectives of the ASHA Special Interest Groups ◽

10.1044/persp2.sig2.110 ◽

2017 ◽

Vol 2 (2) ◽

pp. 110-116

Author(s):

Valarie B. Fleming ◽

Joyce L. Harris

Keyword(s):

Older Adults ◽

African American ◽

Cognitive Impairment ◽

Mild Cognitive Impairment ◽

Healthcare Access ◽

Communication Disorders ◽

Healthcare Systems ◽

Prevention Education ◽

Education Management ◽

African American Adults

Across the breadth of acquired neurogenic communication disorders, mild cognitive impairment (MCI) may go undetected, underreported, and untreated. In addition to stigma and distrust of healthcare systems, other barriers contribute to decreased identification, healthcare access, and service utilization for Hispanic and African American adults with MCI. Speech-language pathologists (SLPs) have significant roles in prevention, education, management, and support of older adults, the population must susceptible to MCI.

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