OECD Ülkelerinde İlaç Harcamalarının Belirleyicileri

Öz

İlaç harcamaları, 1970’ten bu yana GSYİH’nin payı olarak istikrarlı bir şekilde artmaktadır. Bununla birlikte, toplam sağlık harcamaları da artmıştır. Sonuç olarak, ilaç harcamaları OECD ülkelerinde toplam sağlık harcamaları içindeki ortalama payını korumuş ve %15’e yakın bir orana ulaşmıştır. Ülkeler genelinde, kişi başına ilaç harcamaları göreceli gelirlere bağlı olmakla birlikte kurumsal özelliklerden de etkilenmektedir. Bu nedenle, ilaç harcamalarındaki eğilimler, genel sağlık harcama modellerinin belirlenmesinde büyük rol oynamaktadır. İlaç harcamalarındaki eğilimler; mevcut ilaçların fiyatlarındaki değişiklikler, tüketilen hacimdeki dalgalanmalar ve kullanılan ilaçların terapötik bileşimindeki farklılaşmaların birleşiminden kaynaklanabilir. Bu bileşenler ise demografik ve epidemiyolojik eğilimler, ilaç pazarlarının dinamikleri ile tıp uygulamaları ve ilaç politikalarındaki değişiklikler gibi çeşitli faktörlerden etkilenebilir. Bu çalışma, ilaç harcamalarını etkileyen faktörleri belirlemek amacıyla tasarlanmıştır. Çalışmada, OECD veri tabanına kayıtlı 26 ülkeye ait veriler analize dâhil edilmiştir. Araştırma kapsamında, 2015-2022 yıllarını kapsayan dönem incelenmiştir. Çalışmanın amacı doğrultusunda, bağımlı değişken olarak kişi başına yapılan toplam ilaç harcamaları kullanılmıştır. Bağımsız değişkenler ise sağlık harcamalarının GSYİH içindeki payı, bireylerin sağlık algısı, kişi başına gelir, işsizlik oranı, alkol tüketimi, 65 yaş üstü nüfus oranı ve Covid-19 pandemisi olarak belirlenmiştir. Araştırmada panel veri analizi yöntemi uygulanmıştır. Analizler sonucunda, sağlık harcamalarının GSYİH içindeki payının, kişi başına gelirin ve Covid-19 pandemisinin kişi başına yapılan ilaç harcamaları üzerinde pozitif etkisi olduğu bulunmuştur. Ayrıca, işsizlik oranının ve 65 yaş üstü nüfus oranının ilaç harcamaları üzerinde negatif etkisi olduğu tespit edilmiştir. Son olarak, sağlık algısı ve alkol tüketiminin kişi başına yapılan ilaç harcamaları üzerinde anlamlı bir etkisinin bulunmadığı belirlenmiştir. Bu doğrultuda, politika yapıcıların sağlık bütçelerini planlarken yalnızca demografik eğilimlere değil, aynı zamanda ekonomik büyüme dinamiklerine ve istihdam politikalarına da odaklanmaları gerekmektedir.

Anahtar Kelimeler

• Sağlık Hizmeti
• İlaç Harcamaları
• Sağlık Hizmetleri
• Sağlık Harcamaları
• Sosyoekonomik Faktörler

Determinants of Pharmaceutical Expenditures in OECD Countries

Öz

Pharmaceutical expenditure has been increasing steadily as a share of GDP since 1970. However, total health expenditure has also increased. As a result, pharmaceutical expenditure has maintained its average share of total health expenditure in OECD countries, reaching close to 15 percent. Across countries, per capita pharmaceutical expenditures depend on relative incomes but are also influenced by institutional characteristics. Therefore, trends in pharmaceutical expenditures play a major role in determining overall health expenditure patterns. Trends in pharmaceutical expenditure can result from a combination of changes in the prices of available medicines, fluctuations in the volume used, and variations in the therapeutic composition of the medicines used. These components can be influenced by a variety of factors, including demographic and epidemiological trends, the dynamics of pharmaceutical sectors, and changes in medical practice and drug policies. This study is designed to determine the factors affecting pharmaceutical expenditures. In the study, data from 26 countries registered in the OECD database were included in the analysis. Within the scope of the study, the period covering the years 2015-2022 was examined. For the purpose of the study, total per capita pharmaceutical expenditures were used as the dependent variable. The independent variables were determined as the share of health expenditures in GDP, individuals' perception of health, per capita income, unemployment rate, alcohol consumption, population over 65, and the Covid-19 pandemic. The panel data analysis method was applied in the study. As a result of the analyses, it was found that the share of health expenditures in GDP, per capita incomes and the Covid-19 pandemic have a positive effect on per capita drug expenditures. In addition, the unemployment rate and the proportion of the population over the age of 65 have a negative effect on drug expenditures. Finally, health perception and alcohol consumption were found to have no significant effect on per capita drug expenditures. Accordingly, policy makers should focus not only on demographic trends but also on economic growth dynamics and employment policies when planning health budgets.

Anahtar Kelimeler

• Health Care
• Drug Costs
• Health Care
• Health Expenditures
• Socioeconomic Factors

Kaynakça

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