A systematic review of cost-sharing strategies used within publicly-funded drug plans in member countries of the organisation for economic co-operation and development

Lianne Barnieh, Fiona Clement, Anthony Harris, Marja Blom, Cam Donaldson, Scott Klarenbach, Don Husereau, Diane Lorenzetti, Braden Manns

Research output: Contribution to journalArticle


Publicly-funded drug plans vary in strategies used and policies employed to reduce continually increasing pharmaceutical expenditures. We systematically reviewed the utilization of cost-sharing strategies and physician-directed prescribing regulations in publicly-funded formularies within member nations of the Organization of Economic Cooperation and Development (OECD).
Using the OECD nations as the sampling frame, a search for cost-sharing strategies and physician directed prescribing regulations was done using published and grey literature. Collected data was verified by a system expert within the prescription drug insurance plan in each country, to ensure the accuracy of key data elements across plans. Significant variation in the use of cost-sharing mechanisms was seen. Co payments were the most commonly used cost-containment measure, though their use and amount varied for those with certain conditions, most often chronic diseases (in 17 countries), and by socio-economic status (either income or employment status), or with age (in 15 countries).
Original languageEnglish
Issue number3
Publication statusPublished - Mar 2014



  • drug plans
  • cost-sharing
  • public funds
  • health economics

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