Objectives: In this article we investigate the causal effect of cost-sharing schemes on compliance with statins in a quantile regression framework. Methods: We use the health search CSD LPD data, a longitudinal observational dataset containing computer-based patient records collected by Italian general practitioners. We exploit a series of natural experiments referring to several introductions of co-payment schemes in some of the Italian regions between 2000 and 2009. We adopt an extended difference-in-differences approach to provide quantile estimates of the impact of co-payments on compliance. Results: We find that (i) introduction of co-payments hurts residents of regions with worse quality and provision of health care; (ii) within these regions, co-payments were particularly harmful for high compliers; (iii) gender, clinical history and geographic residence are important determinants of compliance among poor compliers; (iv) compliance decreases with the potency and dosage of statins, particularly for poor compliers.

The impact of cost-sharing schemes on drug compliance in Italy: evidence based on quantile regression / Atella, V; Kopinska, J. - In: INTERNATIONAL JOURNAL OF PUBLIC HEALTH. - ISSN 1661-8556. - 59:(2014), pp. 329-339. [10.1007/s00038-013-0528-4]

The impact of cost-sharing schemes on drug compliance in Italy: evidence based on quantile regression

Kopinska J
2014

Abstract

Objectives: In this article we investigate the causal effect of cost-sharing schemes on compliance with statins in a quantile regression framework. Methods: We use the health search CSD LPD data, a longitudinal observational dataset containing computer-based patient records collected by Italian general practitioners. We exploit a series of natural experiments referring to several introductions of co-payment schemes in some of the Italian regions between 2000 and 2009. We adopt an extended difference-in-differences approach to provide quantile estimates of the impact of co-payments on compliance. Results: We find that (i) introduction of co-payments hurts residents of regions with worse quality and provision of health care; (ii) within these regions, co-payments were particularly harmful for high compliers; (iii) gender, clinical history and geographic residence are important determinants of compliance among poor compliers; (iv) compliance decreases with the potency and dosage of statins, particularly for poor compliers.
2014
Compliance; Cost sharing; Difference-in-differences
01 Pubblicazione su rivista::01a Articolo in rivista
The impact of cost-sharing schemes on drug compliance in Italy: evidence based on quantile regression / Atella, V; Kopinska, J. - In: INTERNATIONAL JOURNAL OF PUBLIC HEALTH. - ISSN 1661-8556. - 59:(2014), pp. 329-339. [10.1007/s00038-013-0528-4]
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11573/1439355
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