title: [Impact of the Pharmaceutical Copayment Reform on the Use of Antidiabetics, Antithrombotics and for Chronic Obstructive Airway Disease Agents, Spain].
abstract: OBJECTIVE
  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: -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.
authors.affiliation: Universitat Pompeu Fabra de Barcelona. Departamento de Economía y Empresa. Center for Research in Health and Economics (CRES-UPF) jaume.puig@upf.edu.
authors.forename: Jaume
authors.initials: J
authors.lastname: Puig-Junoy
authors.affiliation: Universidad de las Palmas de Gran Canaria (ULPGC). Departamento de Métodos Cuantitativos en Economía y Gestión.
authors.forename: Santiago
authors.initials: S
authors.lastname: Rodríguez-Feijóo
authors.affiliation: Universidad de las Palmas de Gran Canaria (ULPGC). Departamento de Métodos Cuantitativos en Economía y Gestión.
authors.forename: Beatriz
authors.initials: B
authors.lastname: González López-Valcárcel
authors.affiliation: IMS Health. Madrid.
authors.forename: Vanessa
authors.initials: V
authors.lastname: Gómez-Navarro
mesh_terms: D001993:Bronchodilator Agents / Q000191:economics / Q000627:therapeutic use; D003669:Deductibles and Coinsurance / Q000331:legislation & jurisprudence*; D017723:Drug Utilization Review; D005343:Fibrinolytic Agents / Q000191:economics / Q000627:therapeutic use*; D005102:Health Expenditures; D006801:Humans; D007004:Hypoglycemic Agents / Q000191:economics / Q000627:therapeutic use*; D065186:Interrupted Time Series Analysis; D016014:Linear Models; D008297:Male; D029424:Pulmonary Disease, Chronic Obstructive / Q000188:drug therapy*; D012189:Retrospective Studies; D013030:Spain
chemical_list: D001993:Bronchodilator Agents; D005343:Fibrinolytic Agents; D007004:Hypoglycemic Agents
keywords: Agents, Antidiabetic; Asthma; Chronic Airflow Obstruction; Drug utilization; Economics, Pharmaceutical; Health care reform; Interrupted Time Series Analysis; Legislation, Pharmacy; Pharmacies; Spain