Abstract
BackgroundThere are few studies comparing pharmaceutical costs and the use of medications between immigrants and the autochthonous population in Spain. The objective of this study is to evaluate whether there are differences in pharmaceutical consumption and expenses between immigrant and Spanish-born populations.MethodsProspective observational study in 1,630 immigrants and 4,154 Spanish-born individuals visited by fifteen primary care physicians at five public Primary Care Clinics (PCC) during 2005 in the city of Lleida, Catalonia (Spain). Data on pharmaceutical consumption and expenses was obtained from a comprehensive computerized data-collection system. Multinomial regression models were used to estimate relative risks and confidence intervals of pharmaceutical expenditure, adjusting for age and sex.ResultsThe percentage of individuals that purchased medications during a six-month period was 53.7% in the immigrant group and 79.2% in the autochthonous group. Pharmaceutical expenses and consumption were lower in immigrants than in autochthonous patients in all age groups and both genders. The relative risks of being in the highest quartile of expenditure, for Spanish-born versus immigrants, were 6.9, 95% CI = (4.2, 11.5) in men and 5.3, 95% CI = (3.5, 8.0) in women, with the reference category being not having any pharmaceutical expenditure.ConclusionPharmaceutical expenses are much lower for immigrants with respect to autochthonous patients, both in the percentage of prescriptions filled at pharmacies and the number of containers of medication obtained, as well as the prices of the medications used. Future studies should explore which factors explain the observed differences in pharmaceutical expenses and if these disparities produce health inequalities.
Highlights
There are few studies comparing pharmaceutical costs and the use of medications between immigrants and the autochthonous population in Spain
Setting Lleida is a city located in northeast Spain, in the autonomic region of Catalonia, with approximately 130,000 inhabitants, of which roughly 22,000 are immigrants
Individuals of Latin American (30%) origin predominated in the immigrant group, followed by individuals from the Maghreb (27%)
Summary
There are few studies comparing pharmaceutical costs and the use of medications between immigrants and the autochthonous population in Spain. The objective of this study is to evaluate whether there are differences in pharmaceutical consumption and expenses between immigrant and Spanish-born populations. In 1996, immigrants represented 1.4% of the total Spanish population, and by 2006 had reached 10.8% [1]. In Spain, immigrants may register in their municipality of residence to have access to health care, regardless of their legal status. A number of immigrants are not registered because they are unaware of the process, fear legal authorities' access to the database, or their municipal government rejects their registration [3]. Primarily of sub-Saharan origin, wait for weeks to register with the municipal authorities because they do not have a passport or other documentation to validate their identity.
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