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Consequences of cost barriers to prescriptions: cohort study in Aotearoa New Zealand

journal contribution
posted on 2024-05-23, 22:22 authored by Mona Jeffreys, Megan PledgerMegan Pledger, Fiona McKenzie, Lis Ellison-Loschmann, Maite Irurzun Lopez, Jacqueline Cumming
aims: A NZ$5 co-payment prescription charge was removed in July 2023 but may be reinstated. Here we quantify the health impact and cost of not being able to afford this charge. methods: We linked New Zealand Health Surveys (2013/2014–2018/2019) to hospitalisation data using data available in Integrated Data Infrastructure (IDI). Cox proportional-hazards models compared time to hospitalisation between those who had faced a cost barrier to collecting a prescription and those who had not. results: Of the 81,626 total survey respondents, 72,243 were available for analysis in IDI. A further 516 were excluded to give an analysis dataset of 71,502. Of these, 5,889 (8.2%) reported not collecting a prescription due to cost in the previous year. Among people who faced a cost barrier, 60.0% (95% confidence interval [CI] 58.7–61.2%) were admitted to hospital during the study period, compared to 43.9% (95% CI 43.6–44.3%) of those who did not. Having adjusted for socio-demographic variables, people who faced a cost barrier were 34% (hazard ratio 1.34; 95% CI 1.29–1.39) more likely to be admitted to hospital than those who did not. Annual avoidable hospitalisation costs—were prescription co-payments to remain free—are estimated at $32.4 million per year based on the assumption of a causal relationship between unmet need for prescription medicines and subsequent hospitalisation. conclusions: The revenue to the health system from co-payments may be offset by the costs associated with avoidable hospitalisations.


Enhancing Primary Health Care Services to Improve Health in Aotearoa/New Zealand (NSC09a) | Funder: Health Research Council of New Zealand | Grant ID: hrc_78b73f9d


Preferred citation

Jeffreys, M., Pledger, M., McKenzie, F., Ellison-Loschmann, L., Irurzun Lopez, M. & Cumming, J. (2024). Consequences of cost barriers to prescriptions: cohort study in Aotearoa New Zealand. New Zealand Medical Journal, 137(1595), 48-63.

Journal title

New Zealand Medical Journal





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Pasifika Medical Association Group

Publication status

Published online

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