School of Economics, Faculty of Humanities and Social Sciences, The University of Nottingham Ningbo China, Ningbo, China.
Value Health. 2023 Jun;26(6):833-840. doi: 10.1016/j.jval.2023.01.008. Epub 2023 Jan 24.
Rapid growth in pharmaceutical spending is a major challenge in Canada. To control rising costs, the Canadian government implemented a generic pricing policy in 2013, which reduced prices for some prescription generic drugs by roughly 50%. This article explores the effects of the Canadian pricing policy on drug expenditures and drug utilization among seniors.
Using a unique prescription claims data, this article adopts a difference-in-differences methodology to estimate the policy effects, and it further investigates the mechanisms by exploring the demand-side incentives and the role of health insurance design with a triple-difference approach.
Exploiting the policy variation across drugs and provinces, the results suggest that the policy has reduced drug expenditure per capita, largely because of the inelastic demand among seniors. Although the policy leads to lower out-of-pocket costs for seniors facing coinsurance than for those with a fixed copayment, individual utilization and total demand display no differences across cost sharing.
The price regulation in Canada was successful in reducing drug expenditures per capita. The success rests on the interaction with demand-side regulations and demand incentives. The evidence of cost containment in Canada can provide some insights to other countries with similar needs and priority.
医药支出的快速增长是加拿大面临的主要挑战。为了控制不断上涨的成本，加拿大政府于 2013 年实施了通用定价政策，将一些处方类仿制药的价格降低了约 50%。本文探讨了加拿大定价政策对老年人药品支出和药品使用的影响。
本文利用独特的处方报销数据，采用双重差分法来估计政策效果，并通过三重差分法进一步探讨需求方激励机制和医疗保险设计的作用，以探究其作用机制。
利用药品和省份之间的政策差异，结果表明，该政策降低了人均药品支出，这主要是由于老年人的需求缺乏弹性。尽管该政策使面临共付保险的老年人的自付费用低于固定共付额的老年人，但个人利用和总需求在成本分担方面没有差异。
加拿大的价格管制成功地降低了人均药品支出。成功的原因在于与需求方管制和需求激励的相互作用。加拿大在控制成本方面的证据可以为有类似需求和优先事项的其他国家提供一些启示。
