652
ANALYSIS OF RELATIONSHIP BETWEEN CONSUMER BEHAVIOR AND
EFFECTIVENESS OF HEART MEDICINES
Ge gő Tömö i
Depa men o Accoun ing and Finance, Facul y o Economic Sciences, Uni e si y o
Deb ecen, Deb ecen, Hunga y
ge [email protected]
Abs ac : Nowadays many esea ch dealing wi h he ood consume beha io and i s
ela ionship wi h heal h s a us o popula ion, hus he demand o pha maceu ical ma ke . I
is well known ha ca dio ascula diseases such as ischaemic hea diseases a e he mos
common cause o he ea ly and suddenly mo ali y. The highe le el o pha maceu ical
p e en i e echnologies may esul pa ly ha ewe people need o consume hea
medicines due o he heal hy die , on he o he hand ha he he apies can keep low he
hea mo ali y a e inside o all mo ali y. E ec i eness o medicine ea ing hea diseases
is no same in he examined OECD coun ies, which can also be aced back o di e en
ood consump ion due o he same o ms o ea men and he isks o he disease be ween
egions. The examined OECD coun ies we e selec ed based on consume da a
a ailabili y. The a ge o analysis is o esea ch he ela ionship be ween he
„ine ec i eness” o hea medicine consump ion ( ia he hea mo ali y da a) and he
heal h awa eness in ood consump ion ha also shows he subjec i e u ili y o p e en i e
heal h se ices. Du ing he examina ion o p e en i e se ices ma ke i could be conside
only cos ume decisions hose mo i a e e o o ealize and maximize heal h u ili y ha can
ob ain by educing he objec i e likelihood o la e illness (p e en ion de ined by he
educ ion o in luenced isk ac o s). Fo his i has o be elimina ed he impac o all ac o s
in consump ion hose a e no associa ed wi h heal h consciousness – calcula ion o p ice
and income lexibili y se e i . E e y nu i ional cul u e conside ed unheal hy o inco ec ,
which exceeds he c i ical alues exp essed in die e ics ecommenda ions. The da a
desc ibed in a 2 dimensional diag ams, and be ween diag ams he dis ances om
e e ence coun y da a o da a o ano he coun y examine wi h co ela ion coe icien . I
can conclude he e is a s onges connec ion be ween he ca bohyd a e/ a consume a es
and he e ec o medical ea men s han be ween he la e and a o a /p o ein consume
a es. Basically, my esea ch is empi ical and quan i a i e.
Keywo ds: p ice lexibili y, heal h, consump ion, p e en ion, nu i ion, hea diseases
JEL classi ica ion: I15
1. Gene ally In oduc ion
Nowadays many esea ch dealing wi h he ood consump ion based on heal h awa eness
and i s connec ion wi h heal h s a us o popula ion, so he demand o pha maceu ical
ma ke . Acco ding o KEARNEY (2010) he nu i ion ansi ions associa ed wi h ising a es
o obesi y and ch onic diseases such as ca dio ascula disease and cance . Since “ he
heal h budge expendi u es ha e inc eased d ama ically o e he wo ld, due o he
inc easing cos p essu e” (FRANK, 2007), i can sa e se e al ype o expendi u es in
public heal h sec o wi h ollowing heal h conscious nu i ion. O e all, in Eu ope
“ca dio ascula diseases esul mos ly he inabili y o wo k and aising cos s in heal h ca e,
u he mo e classi y as he mos equen causes o ea ly sudden dea h” (KÉKES, 2009).
“The obesi y, smoking, s ess- illed en i onmen , excessi e alcohol consump ion and lack
o physical ac i i y cons i u es a g oup o li es yle- ela ed isk ac o s, which esponsible o
a leas 40% o o al mo ali y in he de eloping coun ies, while 75% o o al mo ali y in he
653
indus ialize coun ies” (GÁRDOS, 2001). In con as , a s a is ical s udy based on na ow
sample con ained by young people clea ly concludes ha knowledge o isk ac o s i sel
has no con ibu ed o li e heal hie (BARANYAI e al., 2006.). Fo example in Hunga y „ he
le el o heal h awa eness is conside ed s able, he majo i y ea comple ely no mally o
oods hose as e good” (KOZÁK, 2009). Acco ding o he Wo ld Heal h S a is ics by WHO
(2014) „ he p eponde ance o noncommunicable diseases (NCDs) such as ischaemic hea
disease and ce eb o ascula disease in cause o dea h ankings is he e o e po en ially
misleading and may no app op ia ely e lec he impac o p ema u e mo ali y”.1„O he
leading 15 causes o YLL, ischaemic hea disease and s oke we e wo o he h ee
causes o which YLL inc eased be ween 2000 and 2012. Such changes also ha e
implica ions o o e all ankings as ischaemic hea disease o e ook lowe espi a o y
in ec ions as he leading cause o YLL in he wo ld” (WHO, 2014).
2. Ma e ial and me hods
The highe le el o pha maceu ical p e en i e echnologies may esul pa ly ha ewe
people need o consume hea medicines due o he heal hy die , on he o he hand ha
he he apies can keep low he hea mo ali y a e inside o he all mo ali y. Acco dingly,
du ing he analysis he au ho illus a e he he o me easons in a diag am ha ha e 2
dimensions: he a e age d ug consump ion pe 1000 people be ween 2000 and 2011 and
he disease speci ic mo ali y a e in he same pe iod (in his case o he ischaemic hea
diseases). In he ood consump ion “depending on he de elopmen al s anda d o he
economy, s uc u al change p oceeds along he ollowing dimensions: asso men -,
con enience-, heal h- and en i onmen al ends and anspa ency o he ma ke ”
(LEHOTA, 2004). Despi e o his he au ho limi ed easons o ood consump ion decisions
only o h ee ac o s: he impac o eal income changes (including ood p ices and he
incomes o cus ome s), he change o ood supply composi ion and a ibu ed speci ics
( ole in nu i ional cul u e, nu ien con en , expe ienced sense o sa is ac ion a e p e ious
as ing, ma ke ing impac , abili y educing hunge ), and he die awa eness which include
he heal h awa eness oo. Du ing he examina ion o p e en i e se ices ma ke i could be
conside only cos ume decisions hose mo i a e e o o ealize and maximize medical
u ili y ha can ob ain by educing he objec i e likelihood o la e illness (p e en ion de ined
by he educ ion o in luenced isk ac o s). Fo his i has o be elimina ed he impac o all
ac o s hose a e no associa ed wi h heal h consciousness. I can be dis inguished h ee
ood ypes: a s, p o eins and ca bohyd a es – om hese ypes a ood baske could
assemble. The consume ’s own decision ha whe he wo h o i d awn up he o me
baske in acco dance wi h he p esc ibed a e in o de o main ain his heal h. The ex en o
de ia ion om he desi able consume baske gi es one o dimensions o analysis: due o
he h ee di e en ypes and i s p esumed e ec s he o me ex en has o show sepa a ely
in e ms o he ene gy a ise om a in kcal, he a e o a /p o ein, he a e o
ca bohyd a e/ a , ege able oils and ish consump ion, hose ha e polyunsa u a ed a s.
The au ho e alua es de ia ion in e ms o he de elopmen o ischemic hea diseases:
e e y nu i ional cul u e conside ed unheal hy o inco ec , which exceeds he c i ical
alues exp essed in die e ics ecommenda ions. Taken in o accoun he exchange a es
used o nu i ional science: a o 9.2 kcal/g, p o ein o 4.2 kcal/g, and ca bohyd a e o 4.1
kcal/g. Mo eo e , based he newes s udies, p esc ibe a e o he ene gy a ise om a is
30% o daily ene gy in ake, he a /p o ein is nea ly 1.5, he ca bohyd a e/ a is
app oxima ely 1.66.
The o he one o dimensions is he eason o consump ion o he gi en die composi ion,
which measu ed by he sum o p ice and income lexibili y: since lowe lexibili y essen ially
means g ea e die awa eness, so he au ho measu es he la e ac o as ecip ocal o
sum o lexibili y a es, while he change o ood supply composi ion conside ed
unchanged. The p ice and income lexibili y calcula ed by he o mula (1).
654
=𝜕󰇛󰇜
𝜕 ∗
󰇛󰇜+𝜕󰇛𝐼󰇜
𝜕𝐼 ∗𝐼
󰇛𝐼󰇜 󰇛󰇜
In his case he ood consume decisions mo i a ing heal h awa eness can be de ec ed
clea ly in he 2 dimensions model i he nu i ional consump ion, hose a e nea ly o he
p esc ibed die composi ions, ha e high die awa eness (so low p ice and income
lexibili y). F om conside ing p e en i e na u e o nu i ion ollows ha o he consume s i
will only be wo h i o gi e up he unheal hie die , which can ha e highe u ili y in o de o
a heal hie one i he u ili y o p e en ion, namely he es ima ed p obabili y o ch onic
disease wi hin 10 yea s nex o he absence o p e en ion, compa ed o he es ima ed
p obabili y nex o p e en ion, would e alua e o highe signi ican ly. Howe e , i die s
ollowed by consume s esul u ili y pe manen ly wi hin he equi ed c i e ia, han die wi h
p e en i e speci ics in eg a e in o he consume cus oms, o his eason man p e e s
hese oods wi hou he u ili y o p e en ion, so in mo i a ion behind consump ion he
bo de be ween he p e en ion aim and ollowing o nu i ional cus oms disappea , bu
since he la e inally also based on he heal h awa eness, he au ho iden i y he impac o
nu i ional cul u e wi h his. The da a desc ibed in a 2 dimensional diag am examine wi h
co ela ion coe icien ( ) o ela i e dis ances (s) om e e ence coun y da a o da a o
ano he coun ies.
=√∆+∆
= ∑󰇛−󰇜󰇛−󰇜
√∑󰇛−󰇜󰇛−󰇜
When se ing up he model, he au ho assume ha he pha macological ea men begin a
he same ime wi h disease eme gence (o cessa ion o symp om con ol), u he mo e
sudden p ema u e mo ali y (be o e li e expec ancy) explained by he ailu e o medica ion.
The s a ing assump ion o he model is ha all membe s o examined popula ions eed as
a e age ( he annual sum o p ice and income lexibili y da a be ween 1996 and 2011
cha ac e ized by quad a ic a e age o hose, which is sui able o handle he di e en sign
a ia ions) based on he OECD S a is ics and FAO da a se ices. Owing o he da a
a ailabili y he examined coun ies a e OECD membe s: Hunga y, Slo akia, Ge many,
I aly, Uni ed Kingdom and No way.
3. Resul s and discussion
I he e ec i eness o hea medicine examined only in he pape , i will no appea so
di e ences be ween coun ies, which would explain by ano he eason han heal h ca e
sys em o dis inc heal h s a us o popula ion. Compa ed his o he ood consump ion, he
di e ences be ween coun y da a can also explain in e ms o di e en nu i ional cul u es.
655
Figu e 1: The e ec i eness o hea medicine consump ion (2000-2012). Sou ce: own
edi ing based on OECD Heal h S a is ics.
Based on Figu e 1 i can diagnose ha be ween Slo akia and No way, u he mo e
Ge many and Hunga y appea much g ea e di e ence in mo ali y a e in ischeamic hea
disease han only di e ences in hea (blood p essu e and choles e ol lowe ing) medicines
consump ion would jus i y. Mo eo e , in he UK nex o ela i ely highe d ug consump ion
he disease-speci ic mo ali y a e is he same as he da a o Ge many (19%). In ela ion o
each o he o six examined coun ies Slo akia is in he leas a ou able si ua ion, since
ela i e o he low hea medicine consump ion, disease-speci ic mo ali y a e is high
(33%), so in Slo akia he a e age e ec i eness o medicinal ea men is ex emely w ong
compa ed o o he coun ies. Howe e , i can explain by he lowe medical a ailabili y, bu
ha canno be said o Hunga y, whe e he mo ali y is he second highes , nex o he
highes medicine consump ion ollowing he UK. Those coun ies a e in he bes posi ion,
whe e beside o lowe medicine demand, he e is also lowe mo ali y a e in ischeamic
hea diseases compa ed o all mo ali y, such as No way and I aly.
In e ms o he a in ake he bes , uppe le qua e o coo dina e-sys em in Figu e 2,
includes no one coun y – Slo akia is he only one whe e – howe e a consump ion is he
lowes , he la e ha e he highes p ice and income lexibili y oo. Despi e o Slo akia,
Ge many s ands ou in ha ela i ely highe a consump ion a e in luenced by die
awa eness, which can explain by di e en in s anda d o li ing. Howe e , i is he wo s
si ua ion oo, since he high a in ake a e a ises om he die a y cul u e ollowed by as
majo i y o Ge mans, which can o med only longe e m. The majo i y o examined
coun ies has low a in ake a e, bu he p ice lexibili y o consump ion is highe , so in his
espec hose a e close o he mos un a o able case. The dispe sion o medicinal da a
canno explain by he di e en o a meals consump ion: he la e is highe in Slo akia
compa ed o No way despi e o he ac ha in No way he e is a g ea e a in ake a e by
5% a he same die awa eness as in Slo akia. Mo eo e , he la ge mo ali y a e in
Hunga y can less a ibu ed o di e en a in ake, while he la e is conside ed o be mo e
die conscious in Ge many.
SVK
HUN
NOR
ITA
GER GBR
350,00 400,00 450,00 500,00
The a a age hea medicine consump ion (daily dose/1000 people)
10%
15%
20%
25%
30%
35%
Mo ali y a e in ischaemic hea diseases





656
Figu e 2: The a e age a consump ion (1996-2011) in six OECD coun ies. Sou ce: own
edi ing based on FAO S a is ics.
Acco ding o he li e a u e he lipop o eins (lipid-p o ein complexes) play an ex emely ole
in causing ischaemic hea diseases by inducing a he oscle osis. Acco ding o i s
composi ion he e a e wo ypes o lipop o ein: high densi y lipop o eins (HDLs) is he
p o ec i e choles e ol, which he LDLs ha deposi ed in essel wall anspo ed back o he
li e whe e i is deg aded, so i HDL le el is low, he isk o a e ioscle osis, hea a ack
and s oke will inc ease – he low densi y lipop o eins (LDLs) inc easing isk o disease
would occu s ongly nex o nu i ional cul u e ha can cha ac e ized by high a con en
ea ing compa ed p o eins. So inadequa e a /p o ein a io enhances he numbe o w ong
choles e ols, which al eady no compensa ed by he le el o p o ec i e choles e ols,
inc easing he chance o occu ence o hype lipidemia and hype ension (high blood
p essu e), hus hese connec wi h he less e ec i eness o medicinal ea men healing
ischaemic hea diseases. Based on da a illus a ed in Figu e 3, I aly, No way and Uni ed
Kingdom ha e he mos a o able a /p o ein a io, howe e , hose ex end could no explain
he leas by high die awa eness in I aly. The wo s a e can be de ec ed in Hunga y, bu
he p ice and income ela ions a e mo e decisi e in ood consump ion han die
consciousness. Compa ed his wi h he a e age consump ion o blood p essu e lowing
medicine, i can consequence ha he medicine u iliza ion de e mined a he by an
awa eness o consump ion o heal hie die (Ge many) han a less heal hy a /p o ein a e,
ha consume less consciously (Hunga y).
3% 4% 5% 6% 7% 8%
De ia ion om he heal hy a e o a in ake (30%)
0,00
0,50
1,00
1,50
Die awa eness o a meals consump ion






GER
SVK
ITA
NOR
HUN
GBR

657
Figu e 3: The a e age a /p o ein nu i ional in ake a e (1996-2011) in six OECD
coun ies. Sou ce: based on FAO S a is ics own edi ing.
Figu e 4: The a e age ca bohyd a e/ a nu i ional in ake a e (1996-2011) in six OECD
coun ies. Sou ce: own edi ing based on FAO S a is ics.
Due o high glycemic-index ca bohyd a e in ake, he suga concen a ion de elops in he
blood causing pe sis en ly highe le el o insulin. I causes ha insulin can connec mo e
1,60 1,70 1,80 1,90
De ia ion om ecommended a e (1.5)
0,00
0,25
0,50
0,75
1,00
Die awa eness o a /p o ein consump ion






GER
SVK
GBR
NOR
ITA
HUN
1,20 1,30 1,40 1,50 1,60
The a a age ca bohyd a e/ a nu i ional in ake
0,25
0,50
0,75
1,00
Die awa eness o ca bohyd a e/ a consump ion





NOR
GER
SVK
GBR
HUN
ITA
658
weakly o he insulin ecep o s o cells, so hose become esis an o he p esence o
insulin, and p oduc ion o hose. The b ain sensing inc eased blood glucose le el, ins uc s
be a cells o p oduce u he insulin, which exhaus due o he esis ance o cells and
con inued high glucose le el, hus insulin de iciency o diabe es de elops, ollowed by
obesi y and ca dio ascula diseases. In e ms o ca bohyd a e/ a nu i ional in ake,
Slo akia is he wo s posi ion, while No way, Hunga y and I aly ha e a e ega ded as he
bes – howe e he die awa eness emains ypical mos ly o No way and he leas o
I aly. Compa ing his o he da a o a /p o ein in ake a es, i is concluded ha he medicine
u iliza ion de e mined a he by he ca bohyd a e/ a in ake a e han he a /p o ein a e.
Table 1: The a e age consump ion o ege able oils and ishes in six OECD coun ies
Consump ion
Ge many
Hunga y
I aly
No way
Slo akia
G ea -
B i ain
Oils
Ra e
2,1%
2,1%
2,6%
1,8%
1,8%
2,1%
Awa eness
1,16
10,79
1,44
14,46
26,32
3,64
Fishes
Ra e
1,4%
0,5%
2,1%
5,3%
1,0%
2,0%
Awa eness
2,39
16,66
1,56
1,76
104,81
1,52
Sou ce: own edi ing based on FAO S a is ics.
In espec o seconda y p e en ion o ischemic hea diseases ele an o conside he
consump ion a io o ood con aining polyunsa u a ed a y acids - ege able oils and ish
con ain polyunsa u a ed a y acids in he la ges p opo ion. The consump ion o ege able
oils, shown in Figu e 5, is a ound 2% o he o al ood consump ion in all examined
coun ies. F om his I alian a e de ia es a li le wi h i s 2.5%, while die awa eness is
su p isingly low in No way.
Al e na i ely, alues o ish consump ion can be al eady de ec ed in a wide in e al: while
in he mos o coun ies ish meals a e ea en in 2% o less compa ed o o al ood (among
o he s in he lowes p opo ion in Hunga y), he die o No wegians de e mined by mo e
han 5% he consump ion o sea ood. Howe e , i conside s ha , in I aly – despi e o he
esul s in he a in ake a es – he nu i ional consciousness o ege able oils and ishes is
ex emely high. Thus he e ec o ollowing Medi e anean die o ood consump ion
mani es s no p ima ily in con ol o nu i ion in ake a es ela ion o each o he s, bu also
insis ence o ce ain ypes o ood, ega dless o i s con en , which e e s o less heal h-
conscious ood consump ion. The co ela ion coe icien s o de ia ions desc ibed in Table
2.
Table 2: Co ela ion be ween nu i ional cul u e and medical ea men
Medical
ea men
Fa
Fa /P o ein
Ca bo-
hyd a e/
a
Vege able
oils
Fishes
Co ela ion
coe icien
1
0,396
-0,575
-0,856
-0,04
-0,23
Sou ce: own edi ing.
Since in his analysis he p esages conside as i ele an , he e is a s onges connec ion
be ween he ca bohyd a e/ a consump ion and he medical ea men .
659
4. Conclusions and Summa y
In conclusion, i s ly, e ec i eness o medicine ea ing hea diseases is no same in he
six examined OECD coun ies, which can also be aced back o di e en ood
consump ion due o he same o ms o ea men and he isks o he disease be ween
egions. The la e , howe e , may be assessed acco ding o se e al c i e ia (nu ien in ake
by i sel and in ela ion o each o he , and consump ion o oods con aining less equen
nu ien s), hose indica e no he same esul s conce ning e ec i eness o medical
ea men . I is concluded ha he medicine u iliza ion de e mined a he by he
ca bohyd a e/ a in ake a e o ish die s han he a /p o ein a e o a consump ion.
Du ing he analysis s a ing ela i e esul s o he six coun ies, in espec o die
awa eness depending on le el o de elopmen , a in ake can explain less, ish
consump ion may explain he mos he di e ences in e ec i eness o medical ea men ,
o he ac o s ha e no explana o y e ec .
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