- to examine how patient charges influence the decision making of consumers and physicians in the case of pharmaceutical expenditures. For the physician, the choices concerned are the choices between the drugs and the choice of patient management. For the consumer, the choices concerned are to follow the physician order and to consume the drug prescribed or to reduce the drug purchase, to switch to OTC medications, or to choose alternative treatments than drugs.
- to use a disease specific approach on a selected number of clinical conditions in order to perform in depth analysis of the influence of costs on decision making processes.
In recent years, almost all governments in Europe have been forced to consider cost containment strategies when facing deficits in health budgets. In order to make decisions about reimbursement policies and in particular, patient charges, in different European countries, policy makers could benefit of exchange of information about the potential impact of various schemes and policy measures. An inadequate redistribution of costs may influence the quality of the provision of medical care. Therefore, more research is called for, especially on how consumers and physicians react when facing changes inpatient charges. Our objective is to examine how patient charges influence the decision making of consumers and physicians, in the case of pharmaceutical expenditures. Our approach differs from earlier studies, which are mainly based on time-series estimations, in the following ways: we conduct an in-depth analysis of the influence of various patient charge systems on decision-making. We use a disease specific approach. We study the decision-making of both physician and consumers in order to describe the main determinants directing drug demand and their reactions to various reimbursement policy schemes. Our research proceeds through five distinct analytical phases from a macro-study of drug use for four selected conditions (mild hypertension, hormone replacement therapy, dyspepsia, and hay fever) in seven Member States to conjoint and multi variate analyses of how patient charges influence consumer and physician decisions. To our knowledge, this is the first attempt to conduct a European transnational. In depth study on the topic. Our research team is multidisciplinary, representing universities; international non-profit organizations and professional heath care organizations in seven Member States. The findings of this research will provide a decision tool to policymakers helping them to re-design reimbursement schemes through out Europe.
Keywords (max10) Patient charge, reimbursement schemes, co-payment, consumers, physicians, pharmaceuticals, conjoints analysis. 04 04