Impact of the pharmaceutical copayment reform on the use of antidiabetics, antithrombotics and drugs for chronic airflow obstructions. Spain

Abstract

Background: In 2012 it changed the Spanish legislation regulating the pharmaceutical copayment by the National Health System (NHS). The objective was to know if the Spanish pharmaceutical copayment reform in 2012 has affected drugs consumptions for chronic diseases such as antidiabetics, antithrombotics and agents against obstructive conditions of the respiratory tract. Methods: Retrospective longitudinal observational study, using general segmented linear regression models for interrupted time series. The variables analyzed were the number of defined daily doses (DDDs) and the amount corresponding to public funding and not public funding from the NHS since September 2010 to August 2015 (T=60). Results: The estimated variation rate of DDDs is negative but decreasing for the three therapeutic subgroups at 6, 12, 24 and 38 months after the intervention: The estimated variation rate of DDDs is negative but decreasing for the most part of the three therapeutic subgroups at 6, 12, 24 and 38 months after the intervention: -0.1% for antidiabetics after 6 months and 0.3% after 38 months; -3.7% for antithrombotics after 6 months and -4.6% after 38 months; -2.7% for asthma and COPD drugs after 6 months and -1.3% after 38 months. A sustained and significant reduction in expenditure was estimated only in the subgroup of asthma and COPD drugs: -5.2% after 6 months, -7.0% after 12 months and after 24 months, and -6.2% after 38 months. Conclusions: The pharmaceutical copayment reform of 2012 led to an immediate and significant reduction in the number of DDDs of all three therapeutic subgroups selected in this study. This level effect is not permanent, as it is accompanied by a change in the growth trend in the post-intervention months, which has partly offset the effect on the level.