Inequalities in medicine use in Central Eastern Europe: an empirical investigation of socioeconomic determinants in eight countries

Vogler, Sabine and Österle, August ORCID: and Mayer, Susanne (2015) Inequalities in medicine use in Central Eastern Europe: an empirical investigation of socioeconomic determinants in eight countries. International Journal for Equity in Health, 14 (124). pp. 1-19. ISSN 1475-9276

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Equitable access to essential medicines is a major challenge for policy-makers world-wide, including Central and Eastern European countries. This study analyses whether socioeconomic determinants influence the use of prescribed and non-prescribed medicines in eight Central and Eastern European countries (Bulgaria, Czech Republic, Hungary, Latvia, Poland, Romania, Slovenia, Slovakia). Further, the study discusses observed (in)equalities in medicine use in the context of the pharmaceutical policy framework and the implementation in these countries. The study is based on cross-sectional data from the first wave of the European Health Interview Survey (2007-2009). Multivariate logistic regression analyses were carried out to determine the association between socioeconomic status and medicine use (prescribed and non-prescribed medicines). This was supplemented by a pharmaceutical policy analysis based on indicators in four policy dimensions (sustainable funding, affordability, availability and accessibility, and rational selection and use of medicines). Overall, the analysis showed a gradient favouring individuals from higher socioeconomic groups in the consumption of non-prescribed medicines in the eight surveyed countries, and for prescribed medicines in three countries (Latvia, Poland, Romania). The pharmaceutical systems in the eight countries were, to varying degrees, characterized by a lack of (public) funding, thus resulting in high and growing shares of private financing (including co-payments for prescribed medicines), inefficiencies in the selection of medicines into reimbursement and limitations in medicines availability. Pharmaceutical policies aiming at reducing inequalities in medicine use require not only a consideration of the role of co-payments and other private expenditure but also adequate investment in medicines and transparent and clear processes regarding the inclusion of medicines into reimbursement. (authors' abstract)

Item Type: Article
Additional Information: The authors gratefully acknowledge the feedback by the participants of the first ATHEA conference (28 November 2014) in Vienna. The authors are also grateful to the members of the Pharmaceutical Pricing and Reimbursement Information (PPRI) network - representatives of competent authorities for pharmaceutical pricing and reimbursement and public payers from today 45, mainly European countries. Several of them were authors of the PPRI Pharma Profiles and information providers of unpublished data on Central and Eastern European countries, which were fed into the pharmaceutical policy analysis. Finally, the authors gratefully acknowledge the constructive comments made by three anonymous reviewers.
Keywords: medicines / access / use / inequalities / education / income / affordability / availability / co-payments
Divisions: Departments > Sozioökonomie > Sozialpolitik
Version of the Document: Published
Variance from Published Version: None
Depositing User: Elena Simukovic
Date Deposited: 25 Apr 2016 15:33
Last Modified: 09 Sep 2020 06:26
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