Determinants of pharmaceutical expenditures of urban households

A time series study in Kermanshah province (Iran)

Authors

  • Ali Kazemi Karyani Ph.D. Student of Health Economics, Research Center for Environmental Determinants of Health, Kermanshah University of Medical Sciences, Kermanshah, Iran

Keywords:

pharmaceutical expenditures, price elasticity, income elasticity, urban households, Kermanshah Province

Abstract

Introduction: In recent decades, the development of medical and pharmaceutical science has led to a heavy financial burden on the government, insurance companies, and the general population. Due to the increasing the cost of pharmaceutical products in the Kermanshah Province, policy makers have tried to identify the factors that resulted in the increases. The aim of this study was to determine the main factors that affect the expenditures for pharmaceutical products by urban households in Kermanshah Province, Iran. 

Methods: This analytical-descriptive study was conducted using time series method. The study population was urban households of Kermanshah Province from 1991 to 2013. The explanatory variables of the log-log model were drug price index (LnDPI), the average income of urban households (LnINC), the number of physicians per 1,000 people (LnPH), and the number of hospital beds per 1,000 people (LnBE).The required data were acquired from the Statistical Center of the Ministry of Health and Medical Education. The unit root was evaluated by the Dickey-Fuller test. Stata v.11 software was used for the statistical analysis.

Results: Coefficients of LnDPI and LnPH were 0.97 and 0.77, respectively, and they were statistically significant (p < 0.05). Also, the coefficients of D. LnINC (first difference of LnINC) and LnBE were 0.34 and 1.8, respectively, and both of them were statistically insignificant (p > 0.05).

Conclusion: The results showed that drugs are non-elastic and essential for households. It should be noted that the health policy makers in Iran should conduct appropriate planning to ensure both the physical and financial accessibility to drugs by urban households. The development of basic and supplementary health insurance coverage, especially for poor populations and urban areas where there are patients with chronic diseases, can be a suitable solution to reduce barriers to acquiring the required drugs.

 

References

Jahangiri G. Estimating the demand for drugs in the Iranian economy (MSc thesis). Tehran University;

(Persian).

Ghanati E, Hadiyan M , Daghighi AR. Economic expenditures of multiple sclerosis medications and

feasibility of providing health insurance policies for medications. Journal of Health Administration. 2011;

(45): 37-54. Available from: http://jha.iums.ac.ir/browse.php?mag_id=45&slc_lang=en&sid=1.

Javidannezhad S. Drug information. Printing and Publication Institute of Tehran University, 1st ed, 1991.

(Persian)

Amani F, Shaker A. Patterns of drug use among urban households in Ardabil. Payavard Salamat, ISSN:

-2665. 2011; 5(5): 33-41 .Available from: http://payavard.tums.ac.ir/search.php?slc_lang=en&sid=1.

Baldini CG, Culley EJ. Estimated cost savings associated with the transfer of office-administered specialty

pharmaceuticals to a specialty pharmacy provider in a Medical Injectable Drug program. J Manag Care

Pharm. 2010; 17(1): 51-9, PMID: 21204590.

Kebriaeezadeh A, Koopaei NN, Abdollahiasl A, Nikfar S, Mohamadi N. Trend analysis of the

pharmaceutical market in Iran; 1997–2010; policy implications for developing countries. Daru J Pharm Sci.

; 21: 52. doi: 10.1186/2008-2231-21-52, PMID: 23805853, PMCID: PMC3718624.

Golestani M, Rasekh H, Imani A. The relationship between pharmaceutical expenditures, health care

expenditures and gross domestic product in Iran: 1999-2008. Pharmaceutical Sciences. 2012; 18(1): 9-17.

Islamic Parliament Research Center of Iran, The study of the pharmaceutical industry after the Islamic

Revolution of Iran. 2006. Available from: http://rc.majlis.ir/fa/report/show/733366.

Homaie Rad E, Vahedi S, Teimourizad A, Esmaeilzadeh F, Hadian M, Torabi Pour A. Comparison of the

effects of public and private health expenditures on the health status: a panel data analysis in eastern

mediterranean countries. Int J Health Policy Manag. 2014; 1(2): 163-7. doi: 10.15171/ijhpm.2013.29,

PMID: 24596857, PMCID: PMC3937925.

Baily MN. Research and development costs and returns: the US pharmaceutical industry. J Polit Econ.

; 80: 70-85. Available from: http://www.jstor.org/stable/1830132?seq=1#page_scan_tab_contents. doi:

/10.1086/259862

Blazer DG, Wu L-T. The epidemiology of at-risk and binge drinking among middle-aged and elderly

community adults: National Survey on Drug Use and Health. Am J Psychiatry.2009; 166 (10): 1162-9. doi:

1176/appi.ajp.2009.09010016, PMID: 19687131.

Emamgholipour Sefiddashti S, Rashidian A, Nakhaee M. Estimation of Medication Demand Function in

Iranian Households using Panel Data, 2004-2011. Hakim Research Journal. 2014; 17(3): 235-41. Available

from: http://www.hakim.hbi.ir/browse.php?a_id=1369&sid=1&slc_lang=en

Ravangard R, Jafari A, Motlagh SN. Drug demand function for Iranian urban households based on

households' budget. Health Scope. 2014; 3(3): 18494.

Rahbar A, Barouni M, Bahrami M, Saber Mahani A. Estimation of Drug Demand Function in Iranian

Urban Population through Household Budget, 1990-2011. Toloo-e-behdasht. 2013; 12(3):44-58. Available

from: http://tbj.ssu.ac.ir/browse.php?a_code=A-10-422-1&slc_lang=en&sid=1&sw=Health.

EbadifardAzar F, Rezapoor A, Rahbar A, Hosseini Shokouh SM. Estimation of the Function of Medicine

Demand in Islamic Republic of Iran. J Mil Med. 2013; 15(2): 163-8.

Samadi A, Homaie Rad E. Determinants of Healthcare Expenditure in Economic Cooperation Organization

(ECO) Countries: Evidence from Panel Cointegration Tests. Int J Health Policy Manag. 2014; 1(1): 63-8.

doi: 10.15171/ijhpm.2013.10, PMID: 24596838, PMCID: PMC3937933.

Abolhalaj M, Bastani P, Ramezanian M, Tamizkar N. Production and consumption financial Process of

drugs in Iranian healthcare market. Develop Countr Stud. 2013; 3(1): 187-91. Available from:

http://www.iiste.org/Journals/index.php/DCS/article/view/3898.

Radyowijati A, Haak H. Improving antibiotic use in low-income countries: an overview of evidence on

determinants. SOC SCI MED. 2003; 57(4): 733-44. doi: 10.1016/S0277-9536(02)00422-7.

Nouraei Motlagh S, Rezapour A, Lotfi F, Safari H, Hadian M. Factors Influencing Pharmaceutical Demand

in Iran: Results from a Regression Study. International Journal of Hospital Research. 2014; 3(2): 93-6.

Available from:

http://ijhr.iums.ac.ir/index.php/index/help/view/editorial/topic/journal/journal/article_6125_1009.html.

Verbeek M. A guide to modern econometrics, 4th ed. John Wiley & Sons 2012. ISBN: 978-1-119-95167-4.

Smith DG. The effects of copayments and generic substitution on the use and costs of prescription drugs.

Inquiry. 1993: 189-98, PMID: 8314607.

Contoyannis P, Hurley J, Grootendorst P, Jeon SH, Tamblyn R. Estimating the price elasticity of

expenditure for prescription drugs in the presence of non-linear price schedules: an illustration from

Quebec, Canada. Health Econ. 2005; 14(9): 909-23. doi: 10.1002/hec.1041, PMID: 16127675.

Shea DG, Terza JV, Stuart BC, Briesacher B. estimating the effects of prescription drug coverage for

Medicare beneficiaries. Health Serv Res. 2007; 42(3): 933-49, PMID: 17489897, PMCID: PMC1955253.

McPake B, Banda EEN. Contracting out of health Services in developing countries. Health Policy Plan.

; 9(1): 25-30. doi: 10.1093/heapol/9.1.25, PMID: 10133098.

WHO/DAP. Competitive mechanisms for public drug supply: options, issues, and cautions (working draft).

Geneva: World Health Organization; 1997.

Folland S, Goodman AC, Stano M. The economics of health and health care, 5th ed. Pearson Prentice Hall

New Jersey, 2007. ISBN-0-13-227942-8, PMCID: PMC2375556.

Haas JS, Phillips KA, Gerstenberger EP, Seger AC. Potential savings from substituting generic drugs for

brand-name drugs: medical expenditure panel survey, 1997–2000. Ann Intern Med. 2005; 142(11): 891-7.

doi: 10.7326/0003-4819-142-11-200506070-00006, PMID: 15941695.

Published

2022-03-08