Drug Expenditure and Cost-Sharing : a New (Age-Old) Controversy

This paper aims at investing a twofold objective: on the one hand it tries to highlight the consequences of the changes in the cost-sharing amount on public drug expenditure and, on the other, to assess whether public and private expenditure may substitute each other, with particular reference to the Italian case. The analysis was carried out both nationwide and on a regional basis for the four-year period from 1997 to 2000, considered jointly, separately and by couples of years. The results of our specific investigations confirm the hypothesis that the variability of expenditure among Regions and time periods is significantly influenced by co-payment exemption.