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Ethnic differences in accessing medication


Monday 12 July 2010 12:30pm

Māori and Pacific peoples are particularly badly affected by cost barriers when trying to access medication, according to latest research from the University of Otago, Wellington.

The new study has just been published in Journal of Epidemiology and Community Health and is based on the long-running Statistics New Zealand Survey of Family Income and Employment (2004-2009), which covers more than 18,000 people.

It shows that Māori and Pacific people are less likely to be able to pick up prescription items because of the cost.

“This is of concern because these ethnic groups not only have less resources but may also have high unmet health needs, therefore deferral of necessary drugs is only going to make their conditions worse,” says lead researcher Dr Santosh Jatrana.

“The result is people who put off buying prescription drugs because of cost are more likely to be admitted to hospital with serious acute conditions as they haven’t purchased medication or gone to their GP.”

The study also points out that deferring medication because of cost cuts across all ethnic groups and New Zealanders generally, but particularly those in the middle and low income levels. Deprivation, poverty, family structure and multiple health problems all play a part in not taking up prescriptions.

In addition, people who reported poor health, high psychological stress and two or more health problems are more likely to defer buying medications, reflecting other international studies, Dr Jatrana says.

Interestingly the middle income group in the study had the lowest rate of prescription uptake.

“This may be because those on middle incomes are not eligible for the subsidies available through community service cards, and therefore the personal cost of going to a GP is higher than for low income groups,” she says.

However, the study is unable to say which aspects of prescription costs, or other factors, are causing the differences found between ethnic groups. The basic subsidised prescription cost in New Zealand is usually $3 per item, and may be a barrier to families with high health needs and very low income, or those on benefits. Although people are eligible for free prescriptions after the first 20 items, the cost of these first 20 items may be difficult to meet.

Other factors restricting uptake of prescriptions relate to whether Māori and Pacific people use medications more and are therefore more likely to defer purchase because of the cumulative cost if some medications are unsubsidised or only partially subsidised.

The researchers say that overall the study points to one main conclusion: It is important to reduce the cost barriers to drug access to improve preventive population health and reduce ethnic health inequalities in New Zealand.

This study was funded by the Health Research Council, the University of Otago, the Accident Compensation Commission and ALAC.

For further information contact

Dr Santosh Jatrana
University of Otago, Wellington
Tel +64 4 918 5071

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