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Modelling the impact of changes to prescription medicine cost-sharing schemes among middle aged and older adults
James Larkin1, Ciaran Prendergast2, Logan T Murry2
1School of Pharmacy and Biomolecular Sciences, RCSI University of Medicine and Health Sciences, Dublin, Ireland; Department of General Practice, RCSI University of Medicine and Health Sciences, Dublin, Ireland.
Objective:
To assess impacts of government changes to prescription medicine co-payments on individuals' out-of-pocket expenditure.
Methods:
Participants were community-dwelling adults primarily aged ≥56 years from The Irish Longitudinal Study on Ageing study. Ireland has two prescription cost-sharing schemes: the General Medical Services (GMS) scheme (primarily low-income populations), involving low monthly payment caps and co-payments, and the Drugs Payment Scheme (DPS) (for others), with higher caps and no co-payment limit. We modelled changes to these schemes implemented between 2016 and 2022 using 2016 data, assessing out-of-pocket prescription medicine expenditure using descriptive statistics and regression analysis.
Results:
Among 4,155 participants with out-of-pocket prescription medicine expenditure, estimated mean annual prescription medicine expenditure for GMS-eligible participants reduced from €117 (95 %CI = €114-120) to €55 (95 %CI = €54-€56) due to post-2016 changes. For DPS-eligible participants, it reduced from €719 (95 %CI = €694-€744) to €555 (95 %CI = €541-€569).
Conclusions:
Co-payment changes led to average savings of €62 for GMS-eligible participants and €174 for DPS-eligible participants. Although absolute savings were smaller for GMS participants, as the scheme is primarily for low-income populations and the relative expenditure reduction was greater for GMS- than DPS-eligible participants, these savings were likely more impactful for GMS-eligible participants. Further reductions in monthly caps and co-payment charges, particularly for low-income populations, warrant consideration.
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