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Factors influencing the variation in GMS prescribing expenditure in Ireland

Overview of attention for article published in Health Economics Review, March 2016
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Title
Factors influencing the variation in GMS prescribing expenditure in Ireland
Published in
Health Economics Review, March 2016
DOI 10.1186/s13561-016-0090-x
Pubmed ID
Authors

A. ConwayLenihan, S. Ahern, S. Moore, J. Cronin, N. Woods

Abstract

Pharmaceutical expenditure growth is a familiar feature in many Western health systems and is a real concern for policymakers. A state funded General Medical Services (GMS) scheme in Ireland experienced an increase in prescription expenditure of 414 % between 1998 and 2012. This paper seeks to explore the rationale for this growth by investigating the composition (Anatomical Therapeutic Chemical (ATC) Group level 1 & 5) and drivers of GMS drug expenditure in Ireland in 2012. A cross-sectional study was carried out on the Health Service Executive-Primary Care Reimbursement Service (HSE-PCRS) population prescribing database (n = 1,630,775). Three models were applied to test the association between annual expenditure per claimant whilst controlling for age, sex, region, and the pharmacology of the drugs as represented by the main ATC groups. The mean annual cost per claimant was €751 (median = €211; SD = €1323.10; range = €3.27-€298,670). Age, sex, and regions were all significant contributory factors of expenditure, with gender having the greatest impact (β = 0.107). Those aged over 75 (β =1.195) were the greatest contributors to annual GMS prescribing costs. As regards regions, the South has the greatest cost increasing impact. When the ATC groups were included the impact of gender is diluted by the pharmacology of the products, with cardiovascular prescribing (ATC 'C') most influential (β = 1.229) and the explanatory power of the model increased from 40 % to 60 %. Whilst policies aimed at cost containment (co-payment charges; generic substitution; reference pricing; adjustments to GMS eligibility) can be used to curtail expenditure, health promotional programs and educational interventions should be given equal emphasis. Also policies intended to affect physicians' prescribing behaviour include guidelines, information (about price and less expensive alternatives) and feedback, and the use of budgetary restrictions could yield savings in Ireland and can be easily translated to the international context.

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Mendeley readers

Mendeley readers

The data shown below were compiled from readership statistics for 30 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Unknown 30 100%

Demographic breakdown

Readers by professional status Count As %
Researcher 8 27%
Student > Master 6 20%
Student > Ph. D. Student 3 10%
Other 2 7%
Professor > Associate Professor 2 7%
Other 2 7%
Unknown 7 23%
Readers by discipline Count As %
Medicine and Dentistry 6 20%
Pharmacology, Toxicology and Pharmaceutical Science 5 17%
Economics, Econometrics and Finance 4 13%
Nursing and Health Professions 2 7%
Social Sciences 2 7%
Other 3 10%
Unknown 8 27%
Attention Score in Context

Attention Score in Context

This research output has an Altmetric Attention Score of 2. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 16 April 2016.
All research outputs
#13,770,674
of 22,858,915 outputs
Outputs from Health Economics Review
#195
of 429 outputs
Outputs of similar age
#151,851
of 300,926 outputs
Outputs of similar age from Health Economics Review
#4
of 9 outputs
Altmetric has tracked 22,858,915 research outputs across all sources so far. This one is in the 38th percentile – i.e., 38% of other outputs scored the same or lower than it.
So far Altmetric has tracked 429 research outputs from this source. They typically receive a little more attention than average, with a mean Attention Score of 5.9. This one has gotten more attention than average, scoring higher than 54% of its peers.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 300,926 tracked outputs that were published within six weeks on either side of this one in any source. This one is in the 48th percentile – i.e., 48% of its contemporaries scored the same or lower than it.
We're also able to compare this research output to 9 others from the same source and published within six weeks on either side of this one. This one has scored higher than 5 of them.