Affordability of Medicines and Patients' Cost Reduction Behaviors: Empirical Evidence Based on SUR Estimates from Italy and the United Kingdom

The aim of the paper is to shed some light on consumers' attitudes to adopting strategies to contain the cost of medication. Using micro-data from an ad hoc survey conducted in Italy and the UK, several hypotheses are tested regarding patients' decision-making behavior and how it is influenced by health status, socio-demographic characteristics and the novel concept of a self-rated affordability measure. Results show that there is a discernable tendency for both UK and Italian patients to use cost reducing strategies and that these strategies are strongly influenced by income and drug affordability problems. These are important findings in two countries, where the National Health System (NHS) should provide health care services that are accessible to all citizens in need, and provide interesting insights for policy makers in other countries, such as USA, where patients have to pay a large share of their drugs out-of-pocket.