Chronic catastrophes: Exploring the concentration and sustained nature of ambulatory prescription drug expenditures in the population of British Columbia, Canada
Section snippets
Data
This population-based study draws on anonymized data from person-specific administrative data describing prescription drug use, demographics, household income, mortality, and diagnostic information. Different records (e.g., health plan registration, medical, hospital, prescription drug use, and death) have been made linkable, with a linkage rate over 95%. Anonymized data for the calendar years from 2001 and 2004 were extracted with the permission of the B.C. Ministry of Health and the B.C.
Results
A total of 4.045 million individuals met our study inclusion criteria in 2004. A total of 3.849 million individuals met our study inclusion criteria in 2001. There were 3.730 million individuals who were alive and met our study inclusion criteria in both 2001 and 2004. Table 1 lists average 2004 ambulatory drug use and expenditure for this population, stratified into the categories of non-users, low-cost users, medium-cost users, and high-cost users. Approximately 35% of the population did not
Discussion
Results from this study confirm that ambulatory prescription drug expenditures are highly concentrated: in 2004, 20% of the population of B.C. accounted for approximately 80% of all prescription drug expenditures. The highest-cost users (5% of the population) accounted for nearly half (48%) of all expenditures. On average, these high-cost users filled prescriptions for more than nine different types of drug that year. They were also likely to have diagnoses of multiple morbidities in medical
Acknowledgements
This research was funded by the Canadian Institute of Health Research (CIHR). Both authors are also supported by the CIHR and the Michael Smith Foundation for Health Research. Gillian Hanley is also supported by the Western Regional Training Centre. Thanks to the reviewers and the editors for their incredibly helpful comments.
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Systematic review of factors affecting pharmaceutical expenditures
2014, Health PolicyCitation Excerpt :There was methodological variation in the studies’ exploration of the factors affecting pharmaceutical expenditures. The methods include: analysis of prescription claims [13] and the structural effect approach [14]; decomposition of pharmaceutical spending growth [15]; dynamics of expenditure through time [16]; decomposition of change in real drug spending using a multiplicative growth equation [17]; decomposition of real drug spending into price, quantity and residual [18,19]; prescription drug expenditures [20–22]; decomposing the growth of pharmaceutical expenditures into three components: treatment expansion; treatment substitution; and price effect [23]; a pharmacoepidemiological model based on incidence, treatment discontinuation and drug user mortality [24];decomposition of the increase in real drug expenditures into a price effect, a volume effect, and a product-mix effect [25]; multiplicative factor equations using index numbers [26–29]; and equations describing changes in age/sex-specific expenditures [30]. Other studies included trend analysis [31–36] and fixed effects using regression analysis and the demographic impact method [37].
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