title: Health insurance, access to prescription medicines and health outcomes in children.
abstract: Ensuring optimal access to medications has received increasing attention as healthcare systems struggle with increasing costs. Although this has been studied extensively in adults, there has been little investigation in pediatric populations, which have different healthcare needs. A literature review was conducted to examine the evidence regarding the relationship between insurance-mediated access to prescription medicines and outcomes in children. In total, 12 studies were classified according to uninsured versus insured, type of insurance provider and impact of family income. The studies demonstrated that insurance coverage and low-cost sharing are both essential to facilitate access to medications. Increased access was consistently observed for insured compared with uninsured children. Access to prescription drugs frequently differed by type of health provider organization. Adequate family income was an important determinant of access to and receipt of prescriptions. Moreover, income-indexed insurance coverage may increase unmet need. Compared with the literature on access to prescription medicines and health outcomes in adults, there have been few studies in children. Further research relating pharmaceutical policies to pediatric health outcomes is needed to strengthen the quality of policy decision making regarding access to prescription medicines for children.
authors.affiliation: Hospital for Sick Children Population Health Sciences, 555 University Avenue, Toronto, ON, M5G 1X8, Canada. wendy.ungar@sickkids.ca
authors.forename: Wendy J
authors.initials: WJ
authors.lastname: Ungar
authors.forename: Rinat
authors.initials: R
authors.lastname: Ariely