Determinants of outofpocket expenditures on prescribed medications in Tajikistan : Implications for healthcare sector reform

Abstract

Purpose

The purpose of this paper is to quantify the impact of socioeconomic characteristics on outof pocket expenditures for prescribed medications in Tajikistan and provide recommendations for healthcare sector reform. The research question in this paper is what household, personal, economic, and health factors help explain expenditures on medications From a theoretical perspective, this paper contributes to the ongoing discussion of outofpocket expenditures in Tajikistan. From a practical perspective, in line with this recent development in the Tajikistan healthcare sector, it helps to develop evidencebased decisionmaking by answering practical questions what factors affect pattern of outofpocket expenditures for prescribed medication Which groups of the population should be granted a discount or feewaiver when buying them

Designmethodologyapproach

Based on microfile data from the most recent crosssectional nationallyrepresentative survey of Tajik households, this paper develops and tests a multivariate model of identifying determinants of outofpocket expenditures on prescribed medications in Tajikistan.

Findings

The paper finds that economic status, chronic illness, disability, number of small children, short supply of necessary drugs, and cardiac and acute illnesses are the strongest determinants of spending for prescribed medications in the country.

Originalityvalue

This paper demonstrates that to ensure accessibility to and affordability of prescribed medications, discounts or feewaivers should be granted to specific categories of households, those in poverty, with chronically ill members and with small children. These discounts or feewaivers should cover prescribed medications for children, longstanding illness as well as for cardiac and acute infectious diseases. Administrative and economic measures should be taken to reduce the extra costs incurred due to the shortage of prescribed medications. Hence, these findings can be used in developing and designing reforms in the Tajikistan healthcare sector.