ArticleBMJ open2018
Quantifying the financial burden of households' out-of-pocket payments on medicines in India: a repeated cross-sectional analysis of National Sample Survey data, 1994-2014.
Article in BMJ open, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 75 papers, 4 of them syntheses that pooled it.
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Who cites it
75 citing papers in PubMed, 4 syntheses or guidelines pooled it.
- Out-of-pocket expenditure on medicine for chronic patients and its economic impact on Indian households: a systematic review and meta-analysis.Frontiers in medicine · 2026Pooled it
- Understanding out-of-pocket expenditure in India: a systematic review.Frontiers in public health · 2025Pooled it
- TFOS lifestyle: Impact of societal challenges on the ocular surface.The ocular surface · 2023Pooled it
- Out-of-Pocket, Catastrophic Health Expenditure and Distress Financing on Non-Communicable Diseases in India: A Systematic Review with Meta-Analysis.Asian Pacific journal of cancer prevention : APJCP · 2021Pooled it
- Gaps in access and trust: essential medicine availability, affordability, and barriers to generic medicine use.Public health action · 2026Article
- Inequities Uncovered: Examining Exclusion in Indian Health Insurance Policies.Healthcare (Basel, Switzerland) · 2026Article
- Out-of-Pocket Expenses in Patients with Psoriasis: A Study from a Tertiary Care Hospital in North India.Indian dermatology online journal · 2026Article
- Financial impact of non-communicable diseases on households with older adults in india: a mixed methods study.BMC geriatrics · 2026Article
- One size does not fit all: income-sensitive thresholds for catastrophic health expenditure.Health policy and planning · 2026Article
- Integrated Management of Cardio-Renal-Metabolic Disorders in India: A Nationwide Physician Survey.Cureus · 2026Article
- Cost of illness of scrub typhus in South India - a population-based, mixed-methods study.PLoS neglected tropical diseases · 2026Article
- Exosomal microRNAs as biomarkers of multimorbidity risk in lean and obese women with polycystic ovary syndrome.Frontiers in molecular biosciences · 2026Review
- Can a bigger budget shrink the bill at the bedside? Public health financing as a route to lower out-of-pocket spending in India.Frontiers in public health · 2026Article
- Examining the cost of outpatient care for female patients: insights from private healthcare services.BMJ global health · 2025Article
- Sex differences in disease burden, utilization, and expenditure on primary health care services in Kerala, India.Scientific reports · 2025Article
- Informal employment and high burden of out-of-pocket healthcare payments among older workers: evidence from the Longitudinal Ageing Study in India.Health policy and planning · 2025Article
- Assessing Surgical Care under the Government‑Funded Health Insurance Scheme-Pradhan Mantri Jan Arogya Yojana in India.Annals of global health · 2025Article
- Un/met: a mixed-methods study on primary healthcare needs of the poorest population in Khyber Pakhtunkhwa province, Pakistan.International journal for equity in health · 2024Article
- Cost-Effectiveness of Test-and-Treat Strategies to Reduce the Antibiotic Prescription Rate for Acute Febrile Illness in Primary Healthcare Clinics in Africa.Applied health economics and health policy · 2024Article
- Health Systems for Rehabilitation - Critical Appraisal of the National Programme for Stroke in India.Journal of Indian Federation of Neurorehabilitation · 2024Article
15 more citing papers are in PubMed but not listed here.
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Authors and funding
3 authors.
Funding
Abstract
objectiveThe objective of this research is to generate new evidence on financial implications of medicines out-of-pocket (OOP) payments for households. Another objective is to investigate which disease conditions contributed to a significant proportion of households' financial burden.
settingAll Indian states including union territories, 1993-2014.
designRepeated cross-sectional household surveys. DATA: Secondary data of nationwide Consumer Expenditure Surveys for the years 1993-1994, 2004-2005 and 2011-2012 and one wave of Social Consumption: Health for the year 2014 from National Sample Survey Organisation. OUTCOME MEASURES: OOP expenditure on healthcare in general and medicines in specific.
resultsTotal OOP payments and medicines OOP payments were estimated to be 6.77% (95% CI 6.70% to 6.84%) and 4.49% (95% CI 4.45% to 4.54%) of total consumption expenditure, respectively, in the year 2011-2012 which marked significant increase since 1993-1994. These proportions were 11.46% (95% CI 11.36% to 11.56%) and 7.60% (95% CI 7.54% to 7.67%) of non-food expenditure, respectively, in the same year. Total OOP payments and medicines OOP payments were catastrophic for 17.9% (95% CI 17.7% to 18.2%) and 11.2% (95% CI 11.0% to 11.4%) households, respectively, in 2011-2012 at the 10% of total consumption expenditure threshold, implying 29 million households incurred catastrophic OOP payments in the year 2011-2012. Further, medicines OOP payments pushed 3.09% (95% CI 2.99% to 3.20%), implying 38 million persons into poverty in the year 2011-2012. Among the leading cause of diseases that caused significant OOP payments are cancers, injuries, cardiovascular diseases, genitourinary conditions and mental disorders.
conclusionsPurchase of medicines constitutes the single largest component of the total OOP payments by households. Hence, strengthening government intervention in providing medicines free in public healthcare facilities has the potential to considerably reduce medicine-related spending and total OOP payments of households and reduction in OOP-induced poverty.
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