IDEAS home Printed from https://ideas.repec.org/a/gam/jijerp/v19y2022i19p12226-d926141.html
   My bibliography  Save this article

How Did Zero-Markup Medicines Policy Change Prescriptions in the Eyes of Patients?—A Retrospective Quasi-Experimental Analysis

Author

Listed:
  • Hanchao Cheng

    (School of Health Policy and Management, Chinese Academy of Medical Sciences & Peking Union Medical College, 5 Dongdansantiao, Dongcheng District, Beijing 100730, China)

  • Yuou Zhang

    (School of Health Policy and Management, Chinese Academy of Medical Sciences & Peking Union Medical College, 5 Dongdansantiao, Dongcheng District, Beijing 100730, China)

  • Jing Sun

    (School of Health Policy and Management, Chinese Academy of Medical Sciences & Peking Union Medical College, 5 Dongdansantiao, Dongcheng District, Beijing 100730, China)

  • Yuanli Liu

    (School of Health Policy and Management, Chinese Academy of Medical Sciences & Peking Union Medical College, 5 Dongdansantiao, Dongcheng District, Beijing 100730, China)

Abstract

Background: China implemented the zero-markup medicines policy to reverse the overuse of medicine in public health institutions, by changing the distorted financing mechanism, which heavily relies on revenue generated from medicines. The zero-markup medicines policy was progressively implemented in city public hospitals from 2015 to 2017. Objective: This study is expected to generate convincing evidence with subjective measurements and contribute to a more comprehensive evaluation of the policy from both objective and subjective perspectives. Methods: This study was based on a large patient-level dataset with a quasi-experimental design. We employed the difference-in-difference (DID) method, combined with propensity score matching methods, to estimate the causal effect of the policy in reducing overprescriptions from the patient perspective. Results: The study estimated a statistically significant increased probability that the responded outpatients denied overprescription in their visiting hospitals. The mean interacted policy effect, in percentage points, of all observations were positive (logit DID model: 0.15, z = 10.27, SE = 0.01; PSM logit DID model: 0.15, z = 10.26, SE = 0.01; PSM logit DID hospital fixed-effect model: 0.12, z = 3.00, SE = 0.04). Discussion: The policy might reduce overprescription in public hospitals from the patient’s perspective. The patient’s attitude is one aspect of a comprehensive policy evaluation. The final concrete conclusion of the policy evaluation can only be made through a systematic review of the studies with rigorous design and with both objective and subjective measurements.

Suggested Citation

  • Hanchao Cheng & Yuou Zhang & Jing Sun & Yuanli Liu, 2022. "How Did Zero-Markup Medicines Policy Change Prescriptions in the Eyes of Patients?—A Retrospective Quasi-Experimental Analysis," IJERPH, MDPI, vol. 19(19), pages 1-11, September.
    • Handle: RePEc:gam:jijerp:v:19:y:2022:i:19:p:12226-:d:926141
    as

    Download full text from publisher

    File URL: https://www.mdpi.com/1660-4601/19/19/12226/pdf
    Download Restriction: no
    File URL: https://www.mdpi.com/1660-4601/19/19/12226/
    Download Restriction: no
    ---><---

    References listed on IDEAS

    as
    1. Linlin Hu & Bright P. Zhou & Shiyang Liu & Zijuan Wang & Yuanli Liu, 2019. "Outpatient Satisfaction with Tertiary Hospitals in China: The Role of Sociodemographic Characteristics," IJERPH, MDPI, vol. 16(19), pages 1-13, September.
    2. Edward C. Norton & Hua Wang & Chunrong Ai, 2004. "Computing interaction effects and standard errors in logit and probit models," Stata Journal, StataCorp LP, vol. 4(2), pages 154-167, June.
    3. Puhani, Patrick A., 2012. "The treatment effect, the cross difference, and the interaction term in nonlinear “difference-in-differences” models," Economics Letters, Elsevier, vol. 115(1), pages 85-87.
    4. Greene, William, 2010. "Testing hypotheses about interaction terms in nonlinear models," Economics Letters, Elsevier, vol. 107(2), pages 291-296, May.
    5. Fu, Hongqiao & Li, Ling & Yip, Winnie, 2018. "Intended and unintended impacts of price changes for drugs and medical services: Evidence from China," Social Science & Medicine, Elsevier, vol. 211(C), pages 114-122.
    6. Rockers, Peter C. & Røttingen, John-Arne & Shemilt, Ian & Tugwell, Peter & Bärnighausen, Till, 2015. "Inclusion of quasi-experimental studies in systematic reviews of health systems research," Health Policy, Elsevier, vol. 119(4), pages 511-521.
    7. Ai, Chunrong & Norton, Edward C., 2003. "Interaction terms in logit and probit models," Economics Letters, Elsevier, vol. 80(1), pages 123-129, July.
    8. Sascha O. Becker & Andrea Ichino, 2002. "Estimation of average treatment effects based on propensity scores," Stata Journal, StataCorp LP, vol. 2(4), pages 358-377, November.
    9. Juan M. Villa, 2016. "diff: Simplifying the estimation of difference-in-differences treatment effects," Stata Journal, StataCorp LP, vol. 16(1), pages 52-71, March.
    Full references (including those not matched with items on IDEAS)

    Citations

    Citations are extracted by the CitEc Project, subscribe to its RSS feed for this item.
    as


    Cited by:

    1. Joosse, Iris R. & Tordrup, David & Glanville, Julie & Mantel-Teeuwisse, Aukje K. & van den Ham, Hendrika A., 2023. "A systematic review of policies regulating or removing mark-ups in the pharmaceutical supply and distribution chain," Health Policy, Elsevier, vol. 138(C).

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Coupe, Tom & Obrizan, Maksym, 2016. "The impact of war on happiness: The case of Ukraine," Journal of Economic Behavior & Organization, Elsevier, vol. 132(PA), pages 228-242.
    2. Balogh, Attila & Creedy, Usha & Wright, Danika, 2022. "Time to acquire: Regulatory burden and M&A activity," International Review of Financial Analysis, Elsevier, vol. 82(C).
    3. Sakaue, Katsuki, 2018. "Informal fee charge and school choice under a free primary education policy: Panel data evidence from rural Uganda," International Journal of Educational Development, Elsevier, vol. 62(C), pages 112-127.
    4. Sanoran, Kanyarat (Lek), 2018. "Auditors’ going concern reporting accuracy during and after the global financial crisis," Journal of Contemporary Accounting and Economics, Elsevier, vol. 14(2), pages 164-178.
    5. Sèna Kimm Gnangnon, 2012. "Structural Vulnerability and Excessive Public Indebtedness in CFA Franc Zone Countries," Working Papers halshs-00749470, HAL.
    6. Fischer, Timo & Henkel, Joachim, 2013. "Complements and substitutes in profiting from innovation—A choice experimental approach," Research Policy, Elsevier, vol. 42(2), pages 326-339.
    7. Siobhan Austen & Rachel Ong & Richard Seymour, 2013. "Alternative Methods of Estimating Interaction Effects in Non-Linear Models," Bankwest Curtin Economics Centre Working Paper series WP1311, Bankwest Curtin Economics Centre (BCEC), Curtin Business School.
    8. Ferreira Sequeda, Maria & Künn, Annemarie & de Grip, Andries, 2016. "Work-related learning and skill development in Europe: Does initial skill mismatch matter?," Research Memorandum 027, Maastricht University, Graduate School of Business and Economics (GSBE).
    9. Giorgia Giovannetti & Enrico Marvasi & Marco Sanfilippo, 2015. "Supply chains and the internationalization of small firms," Small Business Economics, Springer, vol. 44(4), pages 845-865, April.
    10. Irene Mosca & Robert E. Wright, 2020. "The Long-term Consequences of the Irish Marriage Bar," The Economic and Social Review, Economic and Social Studies, vol. 51(1), pages 1-34.
    11. Eschelbach, Martina & Schmidt, Tobias, 2013. "Precautionary motives in short-term cash management: Evidence from German POS transactions," Discussion Papers 38/2013, Deutsche Bundesbank.
    12. Uribe, Ana Maria Tribin & Vargas, Carmiña O. & Bustamante, Natalia Ramírez, 2019. "Unintended consequences of maternity leave legislation: The case of Colombia," World Development, Elsevier, vol. 122(C), pages 218-232.
    13. Manuel Frondel & Colin Vance, 2012. "On Interaction Effects: The Case of Heckit and Two-Part Models," Ruhr Economic Papers 0309, Rheinisch-Westfälisches Institut für Wirtschaftsforschung, Ruhr-Universität Bochum, Universität Dortmund, Universität Duisburg-Essen.
    14. Yujin Jeong & Jordan I. Siegel & Sophie Yu‐Pu Chen & Whitney K. Newey, 2020. "A recentering approach for interpreting interaction effects from logit, probit, and other nonlinear models," Strategic Management Journal, Wiley Blackwell, vol. 41(11), pages 2072-2091, November.
    15. Frondel Manuel & Vance Colin, 2013. "On Interaction Effects: The Case of Heckit and Two-Part Models," Journal of Economics and Statistics (Jahrbuecher fuer Nationaloekonomie und Statistik), De Gruyter, vol. 233(1), pages 22-38, February.
    16. Au Yong Lyn, Audrey, 2022. "Vocational training and employment outcomes of domestic violence survivors: Evidence from Chihuahua City," International Journal of Educational Development, Elsevier, vol. 89(C).
    17. Anders Holm & Mette Ejrnæs & Kristian Karlson, 2015. "Comparing linear probability model coefficients across groups," Quality & Quantity: International Journal of Methodology, Springer, vol. 49(5), pages 1823-1834, September.
    18. Jongkuk Lee & Glenn Hoetker & William Qualls, 2015. "Alliance Experience and Governance Flexibility," Organization Science, INFORMS, vol. 26(5), pages 1536-1551, October.
    19. Achim Hecker & Alois Ganter, 2016. "Organisational And Technological Innovation And The Moderating Effect Of Open Innovation Strategies," International Journal of Innovation Management (ijim), World Scientific Publishing Co. Pte. Ltd., vol. 20(02), pages 1-31, February.
    20. Barbara Dluhosch, 2018. "Trade, Inequality, and Subjective Well-Being: Getting at the Roots of the Backlash Against Globalization," LIS Working papers 741, LIS Cross-National Data Center in Luxembourg.

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:gam:jijerp:v:19:y:2022:i:19:p:12226-:d:926141. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: MDPI Indexing Manager (email available below). General contact details of provider: https://www.mdpi.com .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.