The impact of prescription drug insurance on cost related non-adherence to medications in Canada: A Heckman sample selection approach

Unlike some other high-income counties, Canada does not provide universal prescription drug coverage. The various extent of coverage may left some Canadians vulnerable to cost-related non-adherence (CRNA) to medications. Using data from the 2015 national cycle of the Canadian Community Health Survey...

Descripción completa

Detalles Bibliográficos
Autores principales: Zhang, Qi, Laporte, Audrey
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10411745/
https://www.ncbi.nlm.nih.gov/pubmed/37556420
http://dx.doi.org/10.1371/journal.pone.0289776
_version_ 1785086735695216640
author Zhang, Qi
Laporte, Audrey
author_facet Zhang, Qi
Laporte, Audrey
author_sort Zhang, Qi
collection PubMed
description Unlike some other high-income counties, Canada does not provide universal prescription drug coverage. The various extent of coverage may left some Canadians vulnerable to cost-related non-adherence (CRNA) to medications. Using data from the 2015 national cycle of the Canadian Community Health Survey, we examine the impact of having private and public drug coverage on mitigating the risk of CRNA with a logit model and a Heckman selection model. CRNA was only observed in respondents who had prescriptions to fill, and respondents did not randomly make decisions on whether to get a prescription. This results in a classic sample selection problem. We found a higher estimated probability of reporting CRNA for uninsured respondents from the Heckman selection model than from the logit model. Respondents with government coverage only had a slightly higher probability of reporting CRNA relative to respondents with private coverage. These findings suggest that, without accounting for sample selection, the risk of not having drug insurance coverage is likely to be underestimated. Moreover, despite covering a less healthy cohort of respondents, the government insurance plans reduce risk of CRNA to a comparable level with private insurance.
format Online
Article
Text
id pubmed-10411745
institution National Center for Biotechnology Information
language English
publishDate 2023
publisher Public Library of Science
record_format MEDLINE/PubMed
spelling pubmed-104117452023-08-10 The impact of prescription drug insurance on cost related non-adherence to medications in Canada: A Heckman sample selection approach Zhang, Qi Laporte, Audrey PLoS One Research Article Unlike some other high-income counties, Canada does not provide universal prescription drug coverage. The various extent of coverage may left some Canadians vulnerable to cost-related non-adherence (CRNA) to medications. Using data from the 2015 national cycle of the Canadian Community Health Survey, we examine the impact of having private and public drug coverage on mitigating the risk of CRNA with a logit model and a Heckman selection model. CRNA was only observed in respondents who had prescriptions to fill, and respondents did not randomly make decisions on whether to get a prescription. This results in a classic sample selection problem. We found a higher estimated probability of reporting CRNA for uninsured respondents from the Heckman selection model than from the logit model. Respondents with government coverage only had a slightly higher probability of reporting CRNA relative to respondents with private coverage. These findings suggest that, without accounting for sample selection, the risk of not having drug insurance coverage is likely to be underestimated. Moreover, despite covering a less healthy cohort of respondents, the government insurance plans reduce risk of CRNA to a comparable level with private insurance. Public Library of Science 2023-08-09 /pmc/articles/PMC10411745/ /pubmed/37556420 http://dx.doi.org/10.1371/journal.pone.0289776 Text en © 2023 Zhang, Laporte https://creativecommons.org/licenses/by/4.0/This is an open access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Research Article
Zhang, Qi
Laporte, Audrey
The impact of prescription drug insurance on cost related non-adherence to medications in Canada: A Heckman sample selection approach
title The impact of prescription drug insurance on cost related non-adherence to medications in Canada: A Heckman sample selection approach
title_full The impact of prescription drug insurance on cost related non-adherence to medications in Canada: A Heckman sample selection approach
title_fullStr The impact of prescription drug insurance on cost related non-adherence to medications in Canada: A Heckman sample selection approach
title_full_unstemmed The impact of prescription drug insurance on cost related non-adherence to medications in Canada: A Heckman sample selection approach
title_short The impact of prescription drug insurance on cost related non-adherence to medications in Canada: A Heckman sample selection approach
title_sort impact of prescription drug insurance on cost related non-adherence to medications in canada: a heckman sample selection approach
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10411745/
https://www.ncbi.nlm.nih.gov/pubmed/37556420
http://dx.doi.org/10.1371/journal.pone.0289776
work_keys_str_mv AT zhangqi theimpactofprescriptiondruginsuranceoncostrelatednonadherencetomedicationsincanadaaheckmansampleselectionapproach
AT laporteaudrey theimpactofprescriptiondruginsuranceoncostrelatednonadherencetomedicationsincanadaaheckmansampleselectionapproach
AT zhangqi impactofprescriptiondruginsuranceoncostrelatednonadherencetomedicationsincanadaaheckmansampleselectionapproach
AT laporteaudrey impactofprescriptiondruginsuranceoncostrelatednonadherencetomedicationsincanadaaheckmansampleselectionapproach