title: Lessons from international experience in controlling pharmaceutical expenditure. I: Influencing patients.
abstract: This is the first of three papers to review international policies to control spending on drugs and improve the efficiency of drug use. Policies can target three main groups: patients, prescribing doctors, and the drugs industry. In this paper we examine policies aimed at patients, particularly restrictions on reimbursement (such as prescription charges). Rigorous experimental and quasi-experimental studies suggest that policies to limit the level of reimbursement of drugs reduce the use of essential as well as non-essential drugs and may do more harm than good.
authors.affiliation: Centre for Health Economics, University of York.
authors.forename: N
authors.initials: N
authors.lastname: Freemantle
authors.forename: K
authors.initials: K
authors.lastname: Bloor
mesh_terms: D001294:Attitude to Health; D003363:Cost Control / Q000379:methods; D017047:Cost Sharing; D016527:Drug Costs; D011307:Drug Prescriptions / Q000191:economics; D005102:Health Expenditures; D006291:Health Policy; D006301:Health Services Needs and Demand / Q000191:economics*; D006801:Humans; D010342:Patient Acceptance of Health Care; D012051:Reimbursement Mechanisms; D013222:State Medicine / Q000191:economics; D006113:United Kingdom