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

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Abstract

In this work we investigate the causal impact of cost sharing schemes on drug compliance using a Difference-in-Differences approach within a quantile regression framework. We exploit a series of natural experiments occurred in Italy between 2000 and 2010, referring to the introduction of regional co-payment schemes. We find that co-payments have a negative impact on compliance, causing a reallocation of individuals from the upper to the lower tail of the compliance distribution, thus hurting the already narrow group of good compliers. The empirical evidence suggests also that gender, clinical history and geographic residence are important drivers of compliance, particularly within the group of poor compliers.

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  • Vincenzo Atella & Joanna Kopinska, 2012. "The impact of cost sharing schemes on drug compliance: evidence based on quantile regression," CEIS Research Paper 247, Tor Vergata University, CEIS, revised 27 Jul 2012.
    • Handle: RePEc:rtv:ceisrp:247
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    1. Tullio Jappelli & Luigi Pistaferri & Guglielmo Weber, 2007. "Health care quality, economic inequality, and precautionary saving," Health Economics, John Wiley & Sons, Ltd., vol. 16(4), pages 327-346, April.
    2. David Ridley & Kirsten Axelsen, 2006. "Impact of Medicaid Preferred Drug Lists on Therapeutic Adherence," PharmacoEconomics, Springer, vol. 24(3), pages 65-78, December.
    3. Koenker, Roger W & Bassett, Gilbert, Jr, 1978. "Regression Quantiles," Econometrica, Econometric Society, vol. 46(1), pages 33-50, January.
    4. Vincenzo Atella & Franco Peracchi & Domenico Depalo & Claudio Rossetti, 2006. "Drug compliance, co‐payment and health outcomes: evidence from a panel of Italian patients," Health Economics, John Wiley & Sons, Ltd., vol. 15(9), pages 875-892, September.
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    More about this item

    Keywords

    Compliance; Cost sharing; Quantile regression; Difference-in-Differences; Statins; Cholesterol;
    All these keywords.

    JEL classification:

    • I10 - Health, Education, and Welfare - - Health - - - General
    • I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health
    • I19 - Health, Education, and Welfare - - Health - - - Other

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