19 Oct
2023
Drug Copayments, Child Outcomes, and Intra-family Spillovers
Reducing out-of-pocket costs of medication has been shown to lead to higher use initiation rates in childhood. Less is known, however, about the potentially asymmetric effects of increases in such costs, resulting from a loss in insurance coverage. This paper looks at the expiration of prescription drug copay waivers for children in Slovakia to investigate changes in pharmaceutical use resulting from increasing out-of-pocket costs. Leveraging age thresholds for copay waivers, this paper uses event study analyses to show that increases in out-of-pocket costs reduce prescription drug use, as well as average spending. Using a dataset capturing the universe of prescriptions filled between 2016–2018, we are further able to understand these effects among both chronic and non-chronic users. We trace the effects of these changes in prescription drug use to down-stream health consequences for children, as measured by GP visits and hospitalizations. Linking these data to social security records, we are further able to understand spillovers onto parental health and employment.