Health insurance specific to one type of medical care (e.g., prescription drug coverage) creates a change in medical care consumption behavior, beyond standard moral hazard, arising both from the differential cost-sharing and relative effectiveness of care in producing health. We model the choice of supplemental health insurance among Medicare beneficiaries, their medical care demand, and subse...

Health insurance specific to one type of medical care (e.g., prescription drug coverage) creates a change in medical care consumption, beyond standard moral hazard, arising both from the differential cost-sharing among different types of care and the relative effectiveness of different types of care in producing health. We model the choice of supplemental health insurance among Medicare benefic...

Polypharmacy, defined by the World Health Organisation as "the administration of many drugs at the same time or the administration of an excessive number of drugs" is frequent among the elderly as they often suffer from chronic diseases with concomitant pathologies. If polypharmacy is legitimate in some cases, it can also be inappropriate and in all cases carries the risk of adverse effects or ...

PURPOSE Clinicians often are required to switch prescribed therapy for their patients in response to health plan initiatives for controlling drug expenditures. To explore the effect of these initiatives, we sought clinicians' feedback regarding their practices and processes for switching patients' medications to accommodate insurance coverage. DESIGN Self-administered Intranet-based survey of...

BACKGROUND The literature shows the inverse association between physical activity level (PAL) and chronic diseases that have a significant burden over health care costs. However, in upper-middle income countries and in elderly population this information are scarce. OBJECTIVE To describe the annual drug expenditures for the hypertensive and diabetic elderly population in Brazil and to analyze...

Drug therapy accounts for a major portion of health expenditure. A useful strategy for achieving cost efficient healthcare is drug utilisation research as it forms the basis for making amendments in drug policies and helps in rational drug use. The present observational study was conducted to generate data on drug utilization in inpatients of our tertiary care hospital to identify potential tar...

BACKGROUND Managing expenditures on pharmaceuticals is important for health systems to sustain universal access to necessary medicines. We sought to estimate the size and sources of differences in expenditures on primary care medications among high-income countries with universal health care systems. METHODS We compared data on the 2015 volume and cost per day of primary care prescription dru...

Patients with epilepsy are frequently invited (often by their own GP) to switch from branded to generic anti-epileptic drugs. The main reason for this change in treatment is that generic drugs cost less, and this has important implications in health expenditure control. Despite the “essential similarity” of drugs, the prescription of generic products may, however, expose patients to additional ...

Canada's provincial and territorial governments have expressed an interest in bulk purchasing prescription drugs for many years. We propose they start by purchasing selected generic drugs for the entire population and provide them for little or no cost to patients. This politically popular strategy would significantly reduce drug expenditures and improve population health.

This study estimates how out-of-pocket drug costs could change for vulnerable populations (racial and ethnic minorities, the near-poor, and seniors with a greater burden of chronic conditions) who qualify for the standard Medicare drug benefit. Although the new benefit might be associated with modest-to-moderate declines in out-of-pocket spending for seniors who do not qualify for subsidies, th...