In 2016, Poland introduced a nationwide policy that made prescription drugs free for people aged 75 and older, as long as the medications were prescribed by a health care professional.
The goal was simple: reduce the financial burden of medicine for older adults, many of whom live on fixed incomes.
A new study published in the journal Health Economics shows that the policy made a real difference. On average, seniors’ out-of-pocket spending on medications fell by 23%.
Even more striking, the number of older adults facing “catastrophic” drug expenses—very high medication costs that can seriously strain a household budget—dropped by 62%.
This suggests the policy offered strong financial protection, especially during serious health problems that require expensive treatment.
However, the benefits were not shared equally.
The study found that wealthier households and those living in urban areas gained more from the policy than lower-income or rural households. This may be because higher-income seniors are more likely to visit doctors, receive prescriptions, or access pharmacies regularly.
As a result, while the program reduced overall financial stress, it may have unintentionally widened existing gaps between richer and poorer older adults.
The research also uncovered some unexpected changes in behavior. When people no longer had to worry as much about paying for medications, some adjusted how they spent money in other areas. The study found that certain older adults increased spending on items such as unhealthy foods, alcohol, and cigarettes.
Researchers suggest that when people feel more financially protected against medical costs, they may feel freer to spend money elsewhere, even on goods that could negatively affect their health.
Dr. Krzysztof Zaremba of Instituto Tecnológico Autónomo de México (ITAM), the study’s corresponding author, explained that the program successfully reduced financial stress for many seniors. But he also noted that feeling more “insured” against health expenses can change other spending habits. In some cases, these changes could partially offset the overall health benefits of the policy.
The findings highlight the complex effects of health care reforms.
While eliminating prescription costs can greatly ease financial pressure for older adults, policymakers may also need to consider how such programs influence behavior and whether additional support is needed to ensure the benefits are shared more equally across society.
