CCHE Seminar Series: Drug Copayments, Child Outcomes, and Intra-family Spillovers

Drug Copayments, Child Outcomes, and Intra-family Spillovers

Boriana Miloucheva
Princeton & University of Toronto

Friday October 28, 2022, 10am-12pm, HS Room 108 and Zoom

Abstract: 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 regression discontinuity and 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 and 2018, we are further able to understand heterogeneous effects among both chronic and non-chronic users, and across conditions.

Boriana is a Postdoctoral Research Associate at Princeton’s Center for Health and Wellbeing. In 2023 she will be joining the University of Toronto’s Institute of Health Policy, Management and Evaluation in the Dalla Lana School of Public Health as an Assistant Professor. Her main research interests are Health and Labour Economics, with a focus on understanding the causes and dynamics of changing mortality trends and the opioid epidemic. Her recent postdoctoral work focuses on issues of child mental health and pharmaceutical use.