The international generalisability of evidence for health policy: A cross country comparison of medication adherence following policy change

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dc.contributor.author Sinnott, Sarah-Jo
dc.contributor.author Whelton, Helen
dc.contributor.author Franklin Myers, Jessica
dc.contributor.author Polinski, Jessica Milan
dc.date.accessioned 2021-07-28T10:24:50Z
dc.date.available 2021-07-28T10:24:50Z
dc.date.issued 2016-10-26
dc.identifier.citation Sinnott, S.-J., Whelton, H., Franklin Myers, J. and Polinski, J. M. (2016) 'The international generalisability of evidence for health policy: A cross country comparison of medication adherence following policy change', Health Policy, 121(1), pp. 27-34. doi: 10.1016/j.healthpol.2016.10.009 en
dc.identifier.volume 121 en
dc.identifier.issued 1 en
dc.identifier.startpage 27 en
dc.identifier.endpage 34 en
dc.identifier.issn 0168-8510
dc.identifier.uri http://hdl.handle.net/10468/11600
dc.identifier.doi 10.1016/j.healthpol.2016.10.009 en
dc.description.abstract Copayments for prescriptions may increase morbidity and mortality via reductions in adherence to medications. Relevant data can inform policy to minimise such unintended effects. We explored the generalisability of evidence for copayments by comparing two international copayment polices, one in Massachusetts and one in Ireland, to assess whether effects on medication adherence were comparable. We used national prescription data for public health insurance programmes in Ireland and Medicaid data in the U.S. New users of oral anti-hypertensive, anti-hyperlipidaemic and diabetic drugs were included (total n = 14,259 in U.S. and n = 43,843 in Ireland). We examined changes in adherence in intervention and comparator groups in each setting using segmented linear regression with generalised estimating equations. In Massachusetts, a gradual decrease in adherence to anti-hypertensive medications of -1% per month following the policy occurred. In contrast, the response in Ireland was confined to a -2.9% decrease in adherence immediately following the policy, with no further decrease over the 8 month follow-up. Reductions in adherence to oral diabetes drugs were larger in the U.S. group in comparison to the Irish group. No difference in adherence changes between the two settings for anti-hyperlipidaemic drugs occurred. Evidence on cost-sharing for prescription medicines is not 'one size fits all'. Time since policy implementation and structural differences between health systems may influence the differential impact of copayment policies in international settings. en
dc.description.sponsorship Health Research Board (Grant No PHD/2007/16) en
dc.format.mimetype application/pdf en
dc.language.iso en en
dc.publisher Elsevier B.V. en
dc.rights © 2016, Elsevier B.V. All rights reserved. This manuscript version is made available under the CC BY-NC-ND 4.0 license. en
dc.rights.uri https://creativecommons.org/licenses/by-nc-nd/4.0/ en
dc.subject Pharmaceutical policy en
dc.subject Cost sharing en
dc.subject Medication adherence en
dc.subject Generalisability en
dc.title The international generalisability of evidence for health policy: A cross country comparison of medication adherence following policy change en
dc.type Article (peer-reviewed) en
dc.internal.authorcontactother Helen Whelton, Medicine & Health Office, University College Cork, Cork, Ireland. +353-21-490-3000 Email: h.whelton@ucc.ie en
dc.internal.availability Full text available en
dc.date.updated 2021-07-28T10:16:35Z
dc.description.version Accepted Version en
dc.internal.rssid 421657579
dc.internal.wokid WOS:000392785300004
dc.contributor.funder Health Research Board en
dc.description.status Peer reviewed en
dc.identifier.journaltitle Health Policy en
dc.internal.copyrightchecked Yes
dc.internal.licenseacceptance Yes en
dc.internal.IRISemailaddress h.whelton@ucc.ie en


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© 2016, Elsevier B.V. All rights reserved. This manuscript version is made available under the CC BY-NC-ND 4.0 license. Except where otherwise noted, this item's license is described as © 2016, Elsevier B.V. All rights reserved. This manuscript version is made available under the CC BY-NC-ND 4.0 license.
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