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Distributional Effects of the 2012 Pharmaceutical Co-payment Change in Spain and Simulated Proposals for Improvement

Author

Listed:
  • Cristina Hernández Izquierdo

    (Universidad de La Laguna)

  • Ignacio Abásolo Alessón

    (Universidad de La Laguna)

  • Beatriz González López-Valcárcel

    (Universidad de Las Palmas de Gran Canaria)

Abstract

We analyse the distributional effects of the 2012 pharmaceutical co-payment reform and eleven simulated alternative schemes in the Canary Islands. A random sample of 41,962 residents covered by the Spanish National Health System together with their individual prescription information from one year before to one after the change was used. The Concentration index (CI) was used to compare inequality in private pharmaceutical spending by income levels: CI increases from 0.03 to 0.07 for the working population, being simulation number 11 the most progressive one (CI=0.20). The use of more income ranges increases progressivity of the system slightly, although more suitable models could have been used, combining more progressivity with more sustainable pharmaceutical public expenditures.

Suggested Citation

  • Cristina Hernández Izquierdo & Ignacio Abásolo Alessón & Beatriz González López-Valcárcel, 2024. "Distributional Effects of the 2012 Pharmaceutical Co-payment Change in Spain and Simulated Proposals for Improvement," Hacienda Pública Española / Review of Public Economics, IEF, vol. 249(2), pages 211-240, June.
    • Handle: RePEc:hpe:journl:y:2024:v:249:i:2:p:211-240.
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    References listed on IDEAS

    as
    1. Jaume Puig-Junoy & Santiago Rodríguez-Feijoó & Beatriz Lopez-Valcarcel, 2014. "Paying for Formerly Free Medicines in Spain After 1 Year of Co-Payment: Changes in the Number of Dispensed Prescriptions," Applied Health Economics and Health Policy, Springer, vol. 12(3), pages 279-287, June.
    2. Niels Skipper, 2013. "On The Demand For Prescription Drugs: Heterogeneity In Price Responses," Health Economics, John Wiley & Sons, Ltd., vol. 22(7), pages 857-869, July.
    3. Jaume Puig-Junoy & Pilar Garcia-Gomez & David Casado-Marin, 2011. "Free Medicines thanks to Retirement: Moral Hazard and Hospitalization Offsets in an NHS," Tinbergen Institute Discussion Papers 11-108/3, Tinbergen Institute.
    4. Owen O’Donnell & Stephen O’Neill & Tom Van Ourti & Brendan Walsh, 2016. "conindex: Estimation of concentration indices," Stata Journal, StataCorp LP, vol. 16(1), pages 112-138, March.
    Full references (including those not matched with items on IDEAS)

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    More about this item

    Keywords

    2012 pharmaceutical co-payment reform; Inequality; Redistributive effects; Progressivity; Simulations.;
    All these keywords.

    JEL classification:

    • D63 - Microeconomics - - Welfare Economics - - - Equity, Justice, Inequality, and Other Normative Criteria and Measurement
    • H23 - Public Economics - - Taxation, Subsidies, and Revenue - - - Externalities; Redistributive Effects; Environmental Taxes and Subsidies
    • I14 - Health, Education, and Welfare - - Health - - - Health and Inequality

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