Inequality in Spending on Medicines and Dietary Supplements in Russia: An Empirical Analysis
DOI:
https://doi.org/10.14515/monitoring.2023.6.2473Keywords:
medicines, dietary supplements, health, income, inequality, COVID-19 pandemicAbstract
The article examines access to medicines and dietary supplements in Russian families with different income levels in 2010―2021. Using regression analysis, the authors study both factors of refusal to purchase medicines and dietary supplements and the amount of expenses for them, justifying the need to estimate these indicators by quintile income groups. The empirical analysis is based on the RLMS-HSE data and employs Heckman models, binary choice models, and random effect models for panel data. Along with per capita household income, the authors include other relevant factors that can impact family expenditures on medicines and dietary supplements, namely: health status (multimorbidity, self-assessment of health, doctor visits), education, household composition (the presence of children and pensioners), and place of residence. The study reveals a significant difference in the per capita expenditures on medicines and dietary supplements in different income quintiles: in 2021 this difference reached 2.8 times between the fifth and the first quintiles. Families from the lowest income quintile may refuse to purchase medicines and dietary supplements due to low income, which is not typical for other income quintiles. Health factors are significant for all income quintiles, but their impact increases in higher income quintiles. On the contrary, for the lowest income quintile, income is more important than health factors. Families from the lowest income quintile experienced significant cuts in real spending on medicines and dietary supplements in 2020―2021, despite the increased need for treatment due to the COVID-19 pandemic. In conclusion, among other things, the authors highlight a necessity to develop additional mechanisms for drug provision to respond to unforeseen deterioration in the financial situation of families during periods of crisis.
Acknowledgments. The paper was prepared within the Research Working Group on the Evaluation of Social Policy Programs’ and Measures’ Effectiveness funded by the Faculty of Economic Sciences, HSE University.
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