Substitution between prescribed and over-the-counter medications

Area of Science:

• Health Economics
• Pharmaceutical Policy
• Consumer Health Behavior

Background:

• Understanding over-the-counter (OTC) drug utilization is crucial for healthcare policy.
• Previous research has not fully explored the relationship between insurance generosity and OTC drug use.
• The Health Insurance Experiment (HIE) provides a unique dataset to investigate these dynamics.

Purpose of the Study:

• To examine the use of OTC drugs in a general, nonelderly population.
• To determine if OTC drugs are substituted for prescription drugs based on insurance cost-sharing.
• To analyze the influence of cost sharing, demographics, and access to care on OTC drug consumption.

Main Methods:

• Utilized data from the Health Insurance Experiment (HIE) involving families with varied medical care cost-sharing.
• Experimentally varied out-of-pocket prices for OTC and prescription drugs.
• Employed multivariate methods to analyze bi-weekly health diary data on OTC use, cost sharing, and demographics.
• Selected study sites represented markets with differing physician service access.

Main Results:

• Found no evidence that less generous prescription drug insurance led to substitution with OTC drugs.
• Individuals with complete insurance coverage purchased more of both OTC and prescription drugs.
• Higher education and consumer knowledge correlated with increased OTC drug use and a larger OTC budget share.
• Greater OTC drug use was observed in HIE sites with poorer access to formal medical care, suggesting some self-care substitution.

Conclusions:

• OTC drugs appear to be an adjunct to, rather than a substitute for, formal medical care.
• Increased financial access to formal care is associated with greater OTC drug use.
• Consumer education and knowledge significantly influence OTC drug purchasing behavior.