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What impact do prescription drug charges have on efficiency and equity? Evidence from high-income countries

Marin C Gemmill*, Sarah Thomson and Elias Mossialos

Author Affiliations

LSE Health, London School of Economics and Political Science, Houghton Street, London, WC2A 2AE, UK

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International Journal for Equity in Health 2008, 7:12 doi:10.1186/1475-9276-7-12

Published: 2 May 2008

Abstract

As pharmaceutical expenditure continues to rise, third-party payers in most high-income countries have increasingly shifted the burden of payment for prescription drugs to patients. A large body of literature has examined the relationship between prescription charges and outcomes such as expenditure, use, and health, but few reviews explicitly link cost sharing for prescription drugs to efficiency and equity. This article reviews 173 studies from 15 high-income countries and discusses their implications for important issues sometimes ignored in the literature; in particular, the extent to which prescription charges contain health care costs and enhance efficiency without lowering equity of access to care.