Out of pocket or out of control: A qualitative analysis of healthcare professional stakeholder involvement in pharmaceutical policy change in Ireland

dc.contributor.authorO'Brien, Gary L.
dc.contributor.authorSinnott, Sarah-Jo
dc.contributor.authorO'Flynn, Bridget
dc.contributor.authorWalshe, Valerie
dc.contributor.authorMulcahy, Mark
dc.contributor.authorByrne, Stephen
dc.contributor.funderIrish Research Councilen
dc.date.accessioned2020-03-05T12:07:37Z
dc.date.available2020-03-05T12:07:37Z
dc.date.issued2020-02-28
dc.date.updated2020-03-05T11:59:29Z
dc.description.abstractBackground: Mandatory co-payments attached to prescription medicines on the Irish public health insurance [General Medical Services (GMS)] scheme have undergone multiple iterations since their introduction in October 2010. To date, whilst patients’ opinions on said co-payments have been evaluated, the perspectives of community pharmacists and general practitioners (GPs) have not. Objective: To explore the involvement and perceptions of community pharmacists and GPs on this pharmaceutical policy change. Methods: A qualitative study using purposive sampling alongside snowballing recruitment was used. Nineteen interviews were conducted in a Southern region of Ireland. Data were analysed using the Framework Approach. Results: Three major themes emerged: 1) the withered tax-collecting pharmacist; 2) concerns and prescribing patterns of physicians; and 3) the co-payment system – impact and sustainability. Both community pharmacists and GPs accepted the theoretical concept of a co-payment on the GMS scheme as it prevents moral hazard. However, there were multiple references to the burden that the current method of co-payment collection places on community pharmacists in terms of direct financial loss and reductions in workplace productivity. GPs independently suggested that a co-payment system may inhibit moral hazard by GMS patients in the utilisation of GP services. It was unclear to participants what evidence is guiding the GMS co-payment fee changes. Conclusion: Interviewees accepted the rationale for the co-payment system, but reform is warranted.en
dc.description.sponsorshipIrish Research Council (GOIPG/2016/635)en
dc.description.statusPeer revieweden
dc.description.versionAccepted Versionen
dc.format.mimetypeapplication/pdfen
dc.identifier.citationO'Brien, G. L., Sinnott, S.-J., O'Flynn, B., Walshe, V., Mulcahy, M. and Byrne, S. (2020) 'Out of pocket or out of control: A qualitative analysis of healthcare professional stakeholder involvement in pharmaceutical policy change in Ireland', Health Policy. doi: 10.1016/j.healthpol.2020.02.011en
dc.identifier.doi10.1016/j.healthpol.2020.02.011en
dc.identifier.issn0168-8510
dc.identifier.journaltitleHealth Policyen
dc.identifier.urihttps://hdl.handle.net/10468/9724
dc.language.isoenen
dc.publisherElsevier B.V.en
dc.relation.urihttp://www.sciencedirect.com/science/article/pii/S0168851020300464
dc.rights© 2020, Elsevier B.V. All rights reserved. This manuscript version is made available under the CC BY-NC-ND 4.0 license.en
dc.rights.urihttps://creativecommons.org/licenses/by-nc-nd/4.0/en
dc.subjectGeneral medical servicesen
dc.subjectCo-paymenten
dc.subjectFramework analysisen
dc.subjectHealth policyen
dc.subjectCommunity pharmacyen
dc.subjectPrimary careen
dc.titleOut of pocket or out of control: A qualitative analysis of healthcare professional stakeholder involvement in pharmaceutical policy change in Irelanden
dc.typeArticle (peer-reviewed)en
Files
Original bundle
Now showing 1 - 5 of 5
Loading...
Thumbnail Image
Name:
Binder1.pdf
Size:
864.63 KB
Format:
Adobe Portable Document Format
Description:
Accepted Version
Loading...
Thumbnail Image
Name:
Title Page.docx
Size:
14.42 KB
Format:
Microsoft Word XML
Description:
Author's Original Title Page
Loading...
Thumbnail Image
Name:
Key Points Short Version (002).docx
Size:
12.24 KB
Format:
Microsoft Word XML
Description:
Author's Original Key Points
Loading...
Thumbnail Image
Name:
Manuscript 18022020 Clean (002).docx
Size:
154.66 KB
Format:
Microsoft Word XML
Description:
Author's Original Manuscript
Loading...
Thumbnail Image
Name:
Supp Material 28022020 Clean.docx
Size:
68.18 KB
Format:
Microsoft Word XML
Description:
Author's Original Supplementary Material
License bundle
Now showing 1 - 1 of 1
Loading...
Thumbnail Image
Name:
license.txt
Size:
2.71 KB
Format:
Item-specific license agreed upon to submission
Description: