scholarly journals Can income-based co-payment rates improve disparity? The case of the choice between brand-name and generic drugs

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Yuki Ito ◽  
Konan Hara ◽  
Byung-Kwang Yoo ◽  
Jun Tomio ◽  
Yasuki Kobayashi
Keyword(s):  
Generic Drugs ◽  
Income Group ◽  
High Income ◽  
Medical Expenditure ◽  
High Income Group ◽  
Brand Name ◽  
Income Groups ◽  
Additional Payment ◽  
Brand Name Drugs ◽  
Payment Rate

Abstract Background Higher income population tend to prefer brand-name to generic drugs, which may cause disparity in access to brand-name drugs among income groups. A potential policy that can resolve such disparity is imposing a greater co-payment rate on high-income enrollees. However, the effects of such policy are unknown. We examined how patients’ choice between brand-name and generic drugs are affected by the unique income-based co-payment rates in Japan; 10% for general enrollees and 30% for those with high income among the elderly aged 75 and over. Methods We drew on cross-sectional price variation among commonly prescribed 311 drugs using health insurance claims data from a large prefecture in Japan between October 2013 and September 2014 to identify between-income-group differences in responses to differentiated payments. Results Running 311 multivariate logistic regression models controlling individual demographics, the median estimate indicated that high-income group was 3% (odds ratio = 0.97) less likely to choose a generic drug than the general-income group and the interquartile estimates ranged 0.92–1.02. The multivariate feasible generalized least squares model indicated high-income group’s higher likelihood to choose brand-name drugs than the general-income group without co-payment rate differentiation (p < 0.001). Such gap in the likelihood was attenuated by 0.4% (p = 0.027) with an US$1 increase in the difference in additional payment/month for brand-name drugs between income groups — no gap with US$10 additional payment/month. This attenuation was observed in drugs for chronic diseases only, not for acute diseases. Conclusions Income-based co-payment rates appeared to reduce disparity in access to brand-name drugs across income groups, in addition to reducing total medical expenditure among high-income group who shifted from brand-name drugs to generic ones due to larger drug price differences.

scholarly journals An Analysis of Environmental Efficiency and Environmental Pollution Treatment Efficiency in China’s Industrial Sector

2021 ◽  
Vol 13 (5) ◽  
pp. 2579 ◽  
Author(s):  
Xiao-Ning Li ◽  
Ying Feng ◽  
Pei-Ying Wu ◽  
Yung-Ho Chiu
Keyword(s):  
Environmental Pollution ◽  
Environmental Governance ◽  
Income Group ◽  
Industrial Sector ◽  
High Income ◽  
Environmental Efficiency ◽  
Technical Level ◽  
High Income Group ◽  
Middle Income ◽  
Income Groups

This research adopts the meta Dynamic Directional Distance Functions (DDF) model in order to calculate the environmental efficiency and environmental governance efficiency of China’s industrial sector from 2010 to 2017 from the overall, sub-regional, and sub-provincial perspectives and discusses the technical gaps in regional environmental pollution control and the reasons for ineffective environmental governance. The research results show that the overall level of environmental governance efficiency in China’s industrial sector is relatively high over this time period, and the group frontier calculation results have improved compared to the meta frontier. The actual technical level of the high-income group is closest to the potential technical level, and the upper-middle income group is still far from the potential technical level. The main reason for the ineffective environmental governance of the provinces in the high-income group is ineffective management, while the main reason for ineffective environmental governance of the provinces in the upper-middle-income groups is technical inefficiency. Regardless of high-income groups or upper-middle-income groups, each province’s inefficiency of environmental governance is caused by inefficiency of the input factors.

scholarly journals Consumer Characteristics and Preferences of Rice Attributes Based on the Income Levels in Palembang

2020 ◽  
pp. 16-25
Author(s):  
. Yunita ◽  
. Lifianthi ◽  
Muhammad Arbi
Keyword(s):  
Low Income ◽  
Household Income ◽  
Consumer Preferences ◽  
Income Group ◽  
High Income ◽  
High Income Group ◽  
Rice Cake ◽  
Income Groups ◽  
Head Rice ◽  
Low Income Groups

The study was conducted on 150 respondents living in Palembang city that were randomly selected based on the assumptions of community groups that have high income groups (50 respondents), medium income groups (50 respondents), and low income groups (50 respondents). The purpose of the study is to describe the characteristics of consumers and analyze consumer preferences for rice attributes based on the level of household income in Palembang city. This showed that the characteristics of households from the three level groups, both from the high, medium, and low income groups are very diverse which can influence the decision to choose and buy rice to be consumed. Rice attributes include the level of rice extinction, rice retention, taste of rice, aromatic, type of rice, volume of development, head rice, broken grains, grain groats, lime grains, and color. Household consumer preferences based on the importance level of rice attributes for the very important category most selected in the high and medium income groups are the quality before the rice becomes rice, while the low income group is a resilience factor in rice. Household consumer preferences based on the level of preference for the attribute of rice for the category of very like the most chosen in the high income group is the taste of rice, for the medium income group is rice cake and the low income group is rice and head rice.

scholarly journals Individual Characteristics Associated with Active Travel in Low and High Income Groups in the UK

2021 ◽  
Vol 18 (19) ◽  
pp. 10360
Author(s):  
Emma Lawlor ◽  
Ruth Hunter ◽  
Deepti Adlakha ◽  
Frank Kee ◽  
Mark Tully
Keyword(s):  
Physical Activity ◽  
Marital Status ◽  
Low Income ◽  
Income Group ◽  
Active Travel ◽  
Individual Characteristics ◽  
High Income ◽  
Housing Tenure ◽  
High Income Group ◽  
Income Groups

Active travel (AT) has gained increasing attention as a way of addressing low levels of physical activity. However, little is known regarding the relationship between income and AT. The aim of this study was to investigate characteristics associated with undertaking AT in an adult population and by low- and high-income groups. Data collected from the Physical Activity and the Rejuvenation of Connswater (PARC) study in 2017 were used. Participants were categorised into socio-economic groups according to their weekly household income, and were categorised as participating in ‘no’ AT or ‘some’ AT and ‘sufficient’ AT. Multivariable logistic regression explored characteristics associated with AT in the full cohort, and the low- and high-income groups separately. Variables associated with AT in the low-income group were body mass index (BMI), physical activity self-efficacy, marital status, long term illness, difficulty walking and housing tenure. For the high-income group, BMI, marital status, housing tenure and education were associated with AT. For both income groups, there were consistent positive associations with the action/maintenance phase of the stage of change model across all AT categories. The findings suggest that population sub-groups may benefit from targeted initiatives to support engagement in AT and prevent further widening of inequalities.

scholarly journals International Environmental Efficiency Trends and the Impact of the Paris Agreement

Energies ◽  
2021 ◽  
Vol 14 (15) ◽  
pp. 4503
Author(s):  
Wen-Chi Yang ◽  
Wen-Min Lu ◽  
Alagu Perumal Ramasamy
Keyword(s):  
Low Income ◽  
Dynamic Change ◽  
Income Group ◽  
Paris Agreement ◽  
High Income ◽  
Environmental Efficiency ◽  
High Income Group ◽  
Middle Income ◽  
Income Groups ◽  
The Impact

This study estimates the environmental efficiency of 150 economies during the period of 2010–2017 to understand the environmental efficiency trend worldwide. This research adopts the meta-Malmquist approach to compare and capture the dynamic change in environmental efficiency among different income groups. The empirical results indicate that among the four income groups, only the low-income group suffers from regression in terms of environmental efficiency, while the high-income group achieves the greatest progress. For the high-income group, the source of improvement originates from the frontier shift rather than from efficiency change. By contrast, the improvement of the lower-income groups results from the catching-up effect. With regard to the effect of the Paris Agreement, only the lower middle-income group exhibits a statistical difference between the two periods, and environmental efficiency increases after the adoption of the Paris Agreement. The fight against global warming cannot succeed by relying only on specific countries. The whole world must cooperate and improve together, and thus, additional help must be devoted to the low-income group. The statistical results support that differences exist in terms of environmental efficiency among the four income groups. In particular, the low-income group is deteriorating.

International perspectives on inpatient mental health care

2019 ◽  
pp. 23-32
Author(s):  
Andrew Molodynski
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Mental Health Care ◽  
Inpatient Care ◽  
Systems Approach ◽  
Income Group ◽  
High Income ◽  
Economic Factors ◽  
High Income Group ◽  
International Perspectives

Inpatient care varies enormously, both between countries and regions and within them. These variations are most stark when based on economic factors, but stigma, prevailing societal attitudes, and the role of the family also play a significant part in the amount and quality of mental health care overall. This chapter begins by outlining global economic factors and their impact on provision. It then focuses on the concept of a whole systems approach, looking briefly at the evidence base for different components of services generally seen in high-income group countries. Alternative suggestions to ‘high-income group’ models are discussed as the evidence internationally emanates almost exclusively from a small number of wealthy westernized countries. The chapter ends with a section looking at several internationally important themes in inpatient care and outlining examples of differences between countries in challenges and in solutions to what is one of the longest standing issues in mental health care: how to provide humane, effective inpatient care to those who need it (and not to those who do not).

scholarly journals Assessment of the Socio-Economic Status of Apartments in Kathmandu Valley

2019 ◽  
Vol 6 ◽  
pp. 9-19
Author(s):  
Archana Bade Shrestha
Keyword(s):  
Urban Population ◽  
Economic Status ◽  
Income Group ◽  
High Income ◽  
Urban Fringe ◽  
Kathmandu Valley ◽  
High Income Group ◽  
Commercial Activity ◽  
High Interest Rate ◽  
Growing Population

Nepal is urbanising at a rapid pace. According to CBS 2011 the urban population accounts for 17% and Kathmandu valley shares the highest urban population. The growing population has put immense pressure on land and housing situation in Kathmandu Valley. Apartments came into picture to accommodate the growing population in the less horizontal space of land but all income groups of people could not afford and access to the facilities and space provided in the apartments.  The current scenario in Kathmandu valley depicts that the developers make investments in construction of apartments as a commercial activity rather than to upgrade housing scenario. Despite, due to the high interest rate, formal collateral in the form of land and house and high income of people to repay loans preferred by commercial banks, the economically weaker section and lower income group of people are not eligible to proceed for the loan. The high cost of Apartment units is beyond affordability of EWS and LIG. The rapid increment of population concentration on primate cities like Kathmandu has led to scarcity of land to accommodate the increasing migrants and not only that, it has resulted in the unhygienic condition of living, suffocating and deteriorating urban environment. As a result, the high income group are moving in the urban fringe and it’s always the poor who are trapped in the vulnerable core cities of Kathmandu. The residential shift of rich people to urban fringe has led to the adhoc development with social disparity and inequity amongst the people living in the same areas.

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