Understanding patient and physician responses to various cost-sharing programs for prescription drugs in South Korea: A multilevel analysis

• Published in: Frontiers in public health Vol. 10; p. 924992
• Main Authors: Son, Kyung-Bok, Lee, Eui-Kyung, Lee, Sang-Won
• Format: Journal Article
• Language: English
• Published: Switzerland Frontiers Media S.A 31.08.2022
• Subjects: Cost Sharing; cost-sharing schemes; Humans; Multilevel Analysis; patient response; physician response; Physicians; Prescription Drugs; Public Health; Republic of Korea; South Korea; Republic of Korea; South Korea; patient response; physician response; cost-sharing schemes; prescription drugs
• ISSN: 2296-2565; 2296-2565
• DOI: 10.3389/fpubh.2022.924992

Patient and/or physician responses are a pivotal issue in designing rational cost-sharing programs under health insurance systems. This study aims to understand patient and/or physician responses to cost-sharing programs designed for prescription drugs in South Korea. As a framework, we took advantage of a tiered cost-sharing program, including from copayment to coinsurance (threshold 1) and reduced coinsurance (threshold 2). Given the hierarchical structure of prescriptions nested within patients, we utilized a multilevel analysis to assess effects of various cost-sharing programs on patient and/or physician responses using National Health Insurance claims data from 2018. We found that a tiered cost-sharing program was effective in changing the behaviors of patients and/or physicians. Threshold 1 was found to be more effective than threshold 2 in changing their behaviors. At the prescription level, sensitivity to cost-sharing programs was associated with prescribed days of treatment and locations of prescription. In a similar vein, sensitivity to cost-sharing programs was associated with gender and age group of patients. A simplified cost-sharing program with extended intervals should be considered to rationalize cost-sharing programs. Specifically, a cost-sharing program designed for long-term prescriptions for chronic diseases together with an emphasis on cost transparency is required to better guide price-conscious decisions by patients and/or physicians.