Trial reportBMC health services research2023
Impact of removing prescription co-payments on the use of costly health services: a pragmatic randomised controlled trial.
Trial report in BMC health services research, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 7 papers.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
7 citing papers in PubMed, 12 citations in OpenAlex.
- Health insurance and antibiotic prescription in pharyngitis: a cross-sectional study in Saudi Arabian primary healthcare centers.Frontiers in medicine · 2026Article
- Equity, power and resources in primary health care reform: insights from Aotearoa New Zealand.International journal for equity in health · 2025Article
- Lived experience of affordability as a barrier to prescription medicines: A longitudinal qualitative study.Exploratory research in clinical and social pharmacy · 2025Article
- Social and policy interventions to reduce hospital admissions among socioeconomically disadvantaged groups in OECD countries with universal health care: a systematic review.BMJ public health · 2025Article
- Community pharmacists' views about prescription medicine co-payments and potential implications for equitable access to medicines: a critical realist interpretation.Journal of pharmaceutical policy and practice · 2023Article
- Correction: Impact of removing prescription co-payments on the use of costly health services: a pragmatic randomised controlled trial.BMC health services research · 2023Article
- Does the type of pharmacy used influence medication adherence? A retrospective observational study in Aotearoa, New Zealand.Canadian pharmacists journal : CPJ = Revue des pharmaciens du Canada : RPCArticle
Corrections and comments
- Erratum issued
Authors and funding
8 authors at 3 institutions in 1 country.
Funding
Abstract
objectivesTo determine whether exempting people (with high health needs and living in areas of high deprivation) from a $5 prescription charge reduces hospital use.
designTwo-group parallel prospective randomised controlled trial.
settingPeople living in the community in various regions of New Zealand.
participantsOne thousand sixty one people who lived in areas of high socioeconomic deprivation, and either took medicines for diabetes, took antipsychotic medicines, or had chronic obstructive pulmonary disease (COPD). Of the 1053 who completed the study, just under half (49%) were Māori.
interventionsParticipants were individually randomized (1-1 ratio) to either be exempted from the standard $5 charge per prescription item for one year (2019-2020) (n = 591) or usual care (n = 469). Those in the intervention group did not pay the standard NZ$5 charge, and pharmacies billed the study for these. Participants continued to pay any other costs for prescription medicines. Those in the control group continued to pay all prescription charges for the year although they may have received one-off assistance from other agencies.
main outcome measuresThe primary outcome was length of stay (hospital bed-days). Secondary outcomes presented in this paper included: all-cause hospitalisations, hospitalisations for diabetes/mental health problems/COPD, deaths, and emergency department visits.
resultsThe trial was under-powered because the recruitment target was not met. There was no statistically significant reduction in the primary outcome, hospital bed-days (IRR = 0.68, CI: 0.54 to 1.05). Participants in the intervention group were significantly less likely to be hospitalised during the study year than those in the control group (OR = 0.70, CI: 0.54 to 0.90). There were statistically significant reductions in the number of hospital admissions for mental health problems (IRR = 0.39, CI: 0.17 to 0.92), the number of admissions for COPD (IRR = 0.37, CI: 0.16 to 0.85), and length of stay for COPD (IRR 0.20, CI: 0.07 to 0.60). Apart from all-cause mortality and diabetes length of stay, all measures were better for the intervention group than the control group.
conclusionsEliminating a small co-payment appears to have had a substantial effect on patients' risk of being hospitalised. Given the small amount of revenue gathered from the charges, and the comparative large costs of hospitalisations, the results suggest that these charges are likely to increase the overall cost of healthcare, as well as exacerbate ethnic inequalities.
trial registrationAustralian New Zealand Clinical Trials Registry (ANZCTR): ACTRN12618001486213 registered on 04/09/2018.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.