title: [Prescription drug consumption recovery following the co-payment change: Evidence from a regional health service].
abstract: OBJECTIVE
  In the past few decades, increasing pharmaceutical expenditures in Spain and other western countries led to the adoption of reforms in order to reduce this trend. The aim of our study was to analyze if reforms concerning the pharmaceutical reimbursement scheme in Spain have been associated with changes in the volume and trend of pharmaceutical consumption.
  
  
  METHODS
  Retrospective observational study.
  
  
  METHODS
  Region of Murcia. Prescription drug in primary care and external consultations.
  
  
  METHODS
  Records of prescribed medicines between January 1, 2008 and December 31, 2013.
  
  
  METHODS
  Segmented regression analysis of interrupted time-series of prescription drug consumption.
  
  
  RESULTS
  Dispensing of all five therapeutic classes fell immediately after co-payment changes. The segmented regression model suggested that per patient drug consumption in pensioners may have decreased by about 6.76% (95% CI; -8.66% to -5.19%) in the twelve months after the reform, compared with the absence of such a policy. Furthermore the slope of the series of consumption increased from 6.08 (P<.001) to 12.17 (P<.019).
  
  
  CONCLUSIONS
  The implementation of copayment policies could be associated with a significant decrease in the level of prescribed drug use in Murcia Region, but this effect seems to have been only temporary in the five therapeutic groups analyzed, since almost simultaneously there has been an increase in the growth trend.
authors.affiliation: Departamento de Ciencias Sociosanitarias, Facultad de Medicina, Universidad de Murcia, Murcia, España. Electronic address: diegopablo.sanchez@um.es.
authors.forename: Diego P
authors.initials: DP
authors.lastname: Sánchez
authors.affiliation: Departamento de Ciencias Sociosanitarias, Facultad de Medicina, Universidad de Murcia, Murcia, España.
authors.forename: José J
authors.initials: JJ
authors.lastname: Guillén
authors.affiliation: Departamento de Ciencias Sociosanitarias, Facultad de Medicina, Universidad de Murcia, Murcia, España.
authors.forename: Alberto M
authors.initials: AM
authors.lastname: Torres
authors.affiliation: Departamento de Ciencias Sociosanitarias, Facultad de Medicina, Universidad de Murcia, Murcia, España.
authors.forename: Julián J
authors.initials: JJ
authors.lastname: Arense
authors.affiliation: Departamento de Economía, Facultad de Ciencias de la Empresa, Universidad Politécnica de Cartagena, Cartagena, Murcia, España.
authors.forename: Ángel
authors.initials: Á
authors.lastname: López
authors.affiliation: Departamento de Economía Aplicada, Facultad de Economía y Empresa, Universidad de Murcia, Murcia, España.
authors.forename: Fernando I
authors.initials: FI
authors.lastname: Sánchez
mesh_terms: D004363:Drug Utilization / Q000706:statistics & numerical data*; D006296:Health Services; D006801:Humans; D007356:Insurance, Pharmaceutical Services; D008137:Longitudinal Studies; D055553:Prescription Drugs; D012051:Reimbursement Mechanisms; D012189:Retrospective Studies; D013030:Spain
chemical_list: D055553:Prescription Drugs
keywords: Análisis de series temporales; Co-payment; Copago; Prescription drug use; Time series analysis; Utilización de medicamentos