Participation in pharmaceutical costs and seniors' access to medicines in the Czech Republic.
OBJECTIVE
Analysis of participation in drug costs by seniors in the Czech Republic in connection with seniors' access to pharmacotherapy.


METHODS
Quota-sampled guided interview with 450 respondents visiting pharmacy; ratio of men and women approximately 1:2; age over 60 years; 3 regions of the Czech Republic.


RESULTS
Respondent's income was retirement pension in 80%. More than 55% of respondents did not reach the official state average. Respondents used altogether 1,650 medicines on physician's prescription in the last four weeks. Overall co-payment for medicines was 38,778 CZK, i.e. 86 CZK per patient. Only 27% of respondents used fully reimbursed products. Respondents used together 273 OTC drugs (over-the-counter drugs, e.g. non prescription drugs) in value of 16,540 CZK, i.e. 37 CZK per patient. Average respondent spent on medicines 123 CZK in the last four weeks, i.e. 1.5% of the official state average income. There were respondents, about 10%, searching for the level of co-payment in several pharmacies and more than 8% of respondents had to refuse dispensation of medicines due to co-payment.


CONCLUSIONS
Our study demonstrates that there are patients who may fail to gain access to medication due to co-payment in the Czech Republic. The financial participation in health care costs is generally low in the Czech Republic (8.8% of total health expenditures) but there were differences in co-payment levels in patients ranging from 1 CZK to thousands CZK. In our opinion problem might be in the absence of any instrument limiting the highest individual participation as it is for example in 12-month period in Sweden. In our study co-payments were lower in smaller communities that may be due to better communication between physicians and patients or physicians and pharmacists. We found a critical ethical problem in different levels of co-payment of concrete product.
Davidová
Jana
J
Department of Social and Clinical Pharmacy, Faculty of Pharmacy in Hradec Králové, Charles University in Prague, Czech Republic. davidova@faf.cuni.cz
Ivanovic
Natasa
N
Práznovcová
Lenka
L
D000368:Aged; D017047:Cost Sharing; D018153:Czech Republic; D005252:Fees, Pharmaceutical; D005260:Female; D006297:Health Services Accessibility / Q000191:economics*; D006299:Health Services for the Aged / Q000191:economics*; D054625:Healthcare Disparities / Q000191:economics; D006801:Humans; D007356:Insurance, Pharmaceutical Services / Q000191:economics*; D008297:Male; D008875:Middle Aged; D009313:National Health Programs; D012959:Socioeconomic Factors