Time Series Analysis on the Impact of Generic Substitution and Reference Pricing on Antipsychotic Costs in Finland

Koskinen, Hanna; Mikkola, Hennamari; Saastamoinen, Leena; Ahola, Elina; Martikainen, Jaana E.

doi:10.1016/j.jval.2015.08.014

Cited by 13 publications

(9 citation statements)

References 20 publications

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“…Considering the delay in the implementation of the policy, this study de nes the end of December 2018 as the actual policy intervention time point.Since the time span of data collection is from January 2018 to December 2019, the period from January 1, 2018 to December 31, 2018 is the pre-intervention stage, and 2019.01.01-2019.12.31 is the post-intervention stage.The data cycle is divided into 1 month as a cycle. The ITS model is established to estimate the level and trend change of the evaluation index [15][16]. The regression equation is as follows:…”

Section: Discussionmentioning

confidence: 99%

The Impact of China's Total Medical Insurance Package Payment Based on Compact County Medical Community and Its Implications for Medical Insurance Funds: Evidence from Y County, China

Liu¹,

Yang

et al. 2020

Preprint

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Background:Due to the irrational structure of medical and health resources, uneven distribution, and low level of grassroots services, traditional medical insurance payment methods in China’s underdeveloped areas have not been fully utilized in regulating medical service behaviors and guiding the allocation of medical resources. The medical insurance fund of many regions collapsed, the fund balance rate and compensation rate decreased year by year, and the medical expenses rose rapidly, which seriously affected the enthusiasm of the insured residents. As a results,the sustainable development of the medical insurance fund faced many difficulties and challenges.Based on this, we want to design a medical insurance policy suitable for underdeveloped areas in China to improve the capacity and efficiency of health services and maintain the stability of medical insurance funds.Methods:Collected medical insurance data of Y County in China from 2018 to 2019.The interruption time series(ITS) was used to evaluate the utilization of medical insurance funds in county-level hospitals, primary health service centers, and hospitals outside the medical community.Results:Inpatient expenditure(IE) per capita,out-of-pocket inpatient expenditure(OIE) per capita,and medical insurance expenditure (MIE)per capita in county-level hospitals increased by 84.682, 6.564 and 62.302 yuan per month respectively after the reform; Number of annul discharges persons(NOADP)from basic health service centers increased by 36.899 per month after the reform; IE per capita and MIE per capita increased by 18.624 yuan and 15.767 yuan per month on average after the reform; the residents hospitalized outside CCMC decreased by 9.545 per month on average after the reform. Conclusions:China should further implement the CCMC-based TMIPPM reform to control medical expenses and maintain the stability of medical insurance funds in in more trials.

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Section: Discussionmentioning

confidence: 99%

The Impact of China's Total Medical Insurance Package Payment Based on Compact County Medical Community and Its Implications for Medical Insurance Funds: Evidence from Y County, China

Liu¹,

Yang

et al. 2020

Preprint

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show abstract

“…The advantage of this design is that it can detect a possible underlying secular trend which occurs after the intervention. By adding a control group, it is possible to separate the intervention effect from other confounding effects that may have occurred at the same time [ 25 – 27 ]. In this study, the ATC “C” group of medicines served as a control group because it contained large volumes of orders and it is not subject to the influence of the restrictive intervention tested in this study.…”

Section: Methodsmentioning

confidence: 99%

“…To estimate the effect of the intervention on the outcome variables, the following segmented linear regression model was developed [ 25 ]: …”

Section: Methodsmentioning

confidence: 99%

Effects of prescription restrictive interventions on antibiotic procurement in primary care settings: a controlled interrupted time series study in China

Tang

Liu

Zhang

et al. 2018

Cost Eff Resour Alloc

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BackgroundThe overuse of antibiotics has been identified as a major challenge in regard to the rational prescription of medicines in low and middle income countries. Extensive studies on the effectiveness of persuasive interventions, such as guidelines have been undertaken. There is a dearth of research pertaining to the effects of restrictive interventions. This study aimed to evaluate the impacts of prescription restrictions in relation to types and administration routes of antibiotics on antibiotic procurement in primary care settings in China.MethodsData were drawn from the monthly procurement records of medicines for primary care institutions in Hubei province over a 31-month period from May 2011 to November 2013. We analyzed the monthly procurement volume and costs of antibiotics. Interrupted time series analyses with a difference-in-difference approach were performed to evaluate the effect of the restrictive intervention (started in August 2012) on antibiotic procurement in comparison with those for cardiovascular conditions. Sensitivity tests were performed by replacing outliers using a simple linear interpolation technique.ResultsOver the entire study period, antibiotics accounted for 33.65% of the total costs of medicines procured for primary care institutions: mostly non-restricted antibiotics (86.03%) and antibiotics administered through parenteral routes (79.59%). On average, 17.14 million defined daily doses (DDDs) of antibiotics were procured per month, with the majority (93.09%) for non-restricted antibiotics and over half (52.38%) for parenteral administered antibiotics. The restrictive intervention was associated with a decline in the secular trend of costs for non-restricted oral antibiotics (− 0.36 million Yuan per month, p = 0.029), and for parenteral administered restricted antibiotics (− 0.28 million Yuan per month, p = 0.019), as well as a decline in the secular trend of procurement volume for parenteral administered non-restricted antibiotics (− 0.038 million DDDs per month, p = 0.05).ConclusionsRestrictive interventions are effective in reducing the procurement of antibiotics. However, the effect size is relatively small and antibiotic consumptions remain high, especially parenteral administered antibiotics.

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“…The effect on costs of switching reference drugs for generics is not conclusive yet. There are some findings in Finland showing cost-savings in the short and medium term but not in the long-term (Koskinen et al, 2015). Some savings were also observed in other countries (Husselman et al, 2016).…”

Section: Discussionmentioning

confidence: 86%

Cost variation of antipsychotics in the public health system in Brazil: the implication for health resource use

Razzouk¹

2017

JBES

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Time Series Analysis on the Impact of Generic Substitution and Reference Pricing on Antipsychotic Costs in Finland

Cited by 13 publications

References 20 publications

The Impact of China's Total Medical Insurance Package Payment Based on Compact County Medical Community and Its Implications for Medical Insurance Funds: Evidence from Y County, China

The Impact of China's Total Medical Insurance Package Payment Based on Compact County Medical Community and Its Implications for Medical Insurance Funds: Evidence from Y County, China

Effects of prescription restrictive interventions on antibiotic procurement in primary care settings: a controlled interrupted time series study in China

Cost variation of antipsychotics in the public health system in Brazil: the implication for health resource use

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