ArticleCMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne2017
Drivers of expenditure on primary care prescription drugs in 10 high-income countries with universal health coverage.
Article in CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 21 papers, 1 of them a synthesis that pooled it.
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Who cites it
21 citing papers in PubMed, 1 synthesis or guideline pooled it, 54 citations in OpenAlex.
- Understanding the Cost Consequences of Pharmacist Roles in Managing Long-Term Illnesses: A Systematic Review.Saudi medical journal · 2026Pooled it
- Effect of Physical Activity on Drug Expenditures for the Physical and Mental Health of Primary Care Users.International journal of environmental research and public health · 2026Article
- The impact of proposed price regulations on new patented medicine launches in Canada: a retrospective cohort study.CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne · 2024Article
- Determinants of government spending on primary healthcare: a global data analysis.BMJ global health · 2023Article
- Main drivers of diabetes pharmaceuticals expenditures: evidence from OECD countries and Iran.Journal of diabetes and metabolic disorders · 2023Article
- Determinants of drug expenditure in the Swiss healthcare market in 2006.BMC health services research · 2022Article
- Assessing the Consequences of External Reference Pricing for Global Access to Medicines and Innovation: Economic Analysis and Policy Implications.Frontiers in pharmacology · 2022Article
- Transparency in public pharmaceutical sector: the key informants' perceptions from a developing country.BMC health services research · 2021Article
- Increasing Prevalence and Direct Health Care Cost of Inflammatory Bowel Disease Among Adults: A Population-Based Study From a Western Canadian Province.Journal of the Canadian Association of Gastroenterology · 2021Article
- Comparison of Pharmaceutical Characteristics between Brand-Name Meropenem and Its Generics.Antibiotics (Basel, Switzerland) · 2021Article
- Challenges in maintaining medicine quality while aiming for universal health coverage: a qualitative analysis from Indonesia.BMJ global health · 2021Article
- The Law and Ethics of Switching from Biologic to Biosimilar in Canada.Journal of the Canadian Association of Gastroenterology · 2020Article
- Integrating public preferences into national reimbursement decisions: a descriptive comparison of approaches in Belgium and New Zealand.BMC health services research · 2020Article
- The Contemporary American Drug Overdose Epidemic in International Perspective.Population and development review · 2019Article
- Capacity of Kidney Care in Canada: Identifying Barriers and Opportunities.Canadian journal of kidney health and disease · 2019Article
- How to pay for national pharmacare.CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne · 2018Article
- An evaluation of prescribing trends and patterns of claims within the Preferred Drugs Initiative in Ireland (2011BMJ open · 2018Article
- Prescription drug coverage in Canada: a review of the economic, policy and political considerations for universal pharmacare.Journal of pharmaceutical policy and practice · 2018Review
- Evaluating the effects of Quebec's private-public drug insurance system.CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne · 2017Review
- Drug prices: How do we get to a better place?CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne · 2017Article
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Authors and funding
3 authors at 1 institution in 1 country.
Funding
Abstract
backgroundManaging expenditures on pharmaceuticals is important for health systems to sustain universal access to necessary medicines. We sought to estimate the size and sources of differences in expenditures on primary care medications among high-income countries with universal health care systems.
methodsWe compared data on the 2015 volume and cost per day of primary care prescription drug therapies purchased in 10 high-income countries with various systems of universal health care coverage (7 from Europe, in addition to Australia, Canada and New Zealand). We measured total per capita expenditure on 6 categories of primary care prescription drugs: hypertension treatments, pain medications, lipid-lowering medicines, noninsulin diabetes treatments, gastrointestinal preparations and antidepressants. We quantified the contributions of 5 drivers of the observed differences in per capita expenditures.
resultsAcross countries, the average annual per capita expenditure on the primary care medicines studied varied by more than 600%: from $23 in New Zealand to $171 in Switzerland. The volume of therapies purchased varied by 41%: from 198 days per capita in Norway to 279 days per capita in Germany. Most of the differences in average expenditures per capita were driven by a combination of differences in the average mix of drugs selected within therapeutic categories and differences in the prices paid for medicines prescribed.
interpretationSignificant international differences in average expenditures on primary care medications are driven primarily by factors that contribute to the average daily cost of therapy, rather than differences in the volume of therapy used. Average expenditures were lower among single-payer financing systems that appeared to promote lower prices and the selection of lower-cost treatment options.
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