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How does universal, free prescription drug coverage affect older adults’ finances and behaviors?

02/11/2026

In 2016, Poland introduced a nationwide policy eliminating all out-of-pocket costs for prescription drugs prescribed by healthcare professionals to individuals aged 75 and older. A new study published in Health Economics finds that the policy reduced average out-of-pocket medication spending by 23% and cut catastrophic drug expenses by 62%, indicating substantial financial protection during major health shocks.

The financial gains, however, were not evenly distributed. The evidence suggests that higher-income and urban households benefited more, pointing to the possibility that the policy may have unintentionally widened existing financial disparities among older adults.

The study also documents unintended behavioral responses. With lower medication costs and greater insurance against future health shocks, some older adults increased spending on goods such as unhealthy food, alcohol, and cigarettes.

“The program reduced financial stress for many older adults, which is good news. But when people feel more insured against health costs, they may change other spending habits in ways that can partially offset the policy’s overall impact,” said corresponding author Krzysztof Zaremba, PhD, of Instituto Tecnológico Autónomo de México (ITAM)

URL: https://onlinelibrary.wiley.com/doi/10.1002/hec.70083


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About the Journal
Health Economics is an international health policy journal publishing articles on all aspects of global health economics. We welcome theoretical contributions, empirical studies, and analyses of health policy from the economic perspective. With a wide scope, Health Economics welcomes contributions on the valuation, determinants and definition of health, health care supply and demand, planning and market mechanisms, treatment micro-economics, and health care system performance.

About Wiley      
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