Specific prescription medications as drivers of out-of-pocket payments and cost-related medication non-adherence in the Czech Republic

Abstract

Objective: Out-of-pocket payments for medications take a substantial part of Czech households’ expenditure for health, which could have a negative impact on medication adherence. Therefore, the objective of this study is to explore the impact of prescription medications related to specific health conditions on patients’ out-of-pocket payments and cost-related medication non-adherence. Methods: We used the data from the second wave of the European Health Interview Survey. Running the analyses in hierarchical stages, our main interest was the influence of medications related to 21 health conditions. A conventional regression method with robust standard errors was used for the investigation of out-of-pocket payments for prescription medication. Predictors of cost-related medication nonadherence were identified using a logistic regression model. Results: We found that medications for stroke, asthma, myocardial infarction, chronic lung disease, chronic kidney disease, and diabetes contribute to high co-payments. Moreover, cost sharing for stroke, asthma and myocardial infarction medications might have serious implications for desirable consumption as they are associated with medication non-adherence. Conclusions: We conclude that prescription practices and reimbursement policies in relation to medications for stroke, asthma and myocardial infarction should be carefully explored and physicians should be motivated to prescribe medications covered fully or with low co-payments.