IDEAS home Printed from https://ideas.repec.org/a/wly/hlthec/v15y2006i9p875-892.html
   My bibliography  Save this article

Drug compliance, co‐payment and health outcomes: evidence from a panel of Italian patients

Author

Listed:
  • Vincenzo Atella
  • Franco Peracchi
  • Domenico Depalo
  • Claudio Rossetti

Abstract

This paper studies the relationship between medical compliance and health outcomes – hospitalization and mortality rates – using a large panel of patients residing in a local health authority in Italy. These data allow us to follow individual patients through all their accesses to public health care services until they either die or leave the local health authority. We adopt a disease specific approach, concentrating on hypertensive patients treated with ACE‐inhibitors. Our results show that medical compliance has a clear effect on both hospitalization and mortality rates: health outcomes clearly improve when patients become more compliant to drug therapy. At the same time, we are able to infer valuable information on the role that drug co‐payment can have on compliance, and as a consequence on health outcomes, by exploiting the presence of two natural experiments during the period of analysis. Our results show that drug co‐payment has a strong effect on compliance, and that this effect is immediate. Copyright © 2006 John Wiley & Sons, Ltd.

Suggested Citation

  • 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.
    • Handle: RePEc:wly:hlthec:v:15:y:2006:i:9:p:875-892
    DOI: 10.1002/hec.1135
    as

    Download full text from publisher

    File URL: https://doi.org/10.1002/hec.1135
    Download Restriction: no
    File URL: https://libkey.io/10.1002/hec.1135?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    References listed on IDEAS

    as
    1. Alan, Sule & Crossley, Thomas F. & Grootendorst, Paul & Veall, Michael R., 2002. "The effects of drug subsidies on out-of-pocket prescription drug expenditures by seniors: regional evidence from Canada," Journal of Health Economics, Elsevier, vol. 21(5), pages 805-826, September.
    2. repec:pri:rpdevs:case_leroux_menendez_medical_compliance_and_income_health_gradients_aerpp is not listed on IDEAS
    3. Vincenzo Atella & Peter R. Noyce & Ellen Schafheutle & Karen Hassell, 2005. "Affordability of Medicines and Patients' Cost Reduction Behaviors: Empirical Evidence Based on SUR Estimates from Italy and the United Kingdom," CEIS Research Paper 71, Tor Vergata University, CEIS.
    4. Lundberg, Lena & Johannesson, Magnus & Isacson, Dag G. L. & Borgquist, Lars, 1998. "Effects of user charges on the use of prescription medicines in different socio-economic groups," Health Policy, Elsevier, vol. 44(2), pages 123-134, May.
    5. Anne Case & Ingrid Le Roux & Alicia Menendez, 2004. "Medical Compliance and Income-Health Gradients," American Economic Review, American Economic Association, vol. 94(2), pages 331-335, May.
    6. Leibowitz, Arleen & Manning, Willard G. & Newhouse, Joseph P., 1985. "The demand for prescription drugs as a function of cost-sharing," Social Science & Medicine, Elsevier, vol. 21(10), pages 1063-1069, January.
    7. Sule Alan & Thomas F. Crossley & Paul Grootendorst & Michael R. Veall, 2002. "Out-of-Pocket Prescription Drug Expenditures and Public Prescription Drug Programs," Social and Economic Dimensions of an Aging Population Research Papers 88, McMaster University.
    8. repec:pri:cheawb:case_medicalcompliance.pdf is not listed on IDEAS
    9. M Ryan & S Birch, 1991. "Charging for Health Care: Evidence on the Utilization of NHS Prescribed Drugs," Centre for Health Economics and Policy Analysis Working Paper Series 27, Centre for Health Economics and Policy Analysis (CHEPA), McMaster University, Hamilton, Canada.
    10. repec:pri:rpdevs:case_medicalcompliance is not listed on IDEAS
    11. repec:pri:rpdevs:case_medicalcompliance.pdf is not listed on IDEAS
    12. repec:pri:cheawb:case_medicalcompliance is not listed on IDEAS
    13. Stephane Jacobzone, 2000. "Pharmaceutical Policies in OECD Countries: Reconciling Social and Industrial Goals," OECD Labour Market and Social Policy Occasional Papers 40, OECD Publishing.
    Full references (including those not matched with items on IDEAS)

    Citations

    Citations are extracted by the CitEc Project, subscribe to its RSS feed for this item.
    as


    Cited by:

    1. Vanessa Cirulli & Giuliano Resce & Marco Ventura, 2024. "Co-payment exemption and healthcare consumption: quasi-experimental evidence from Italy," Empirical Economics, Springer, vol. 67(1), pages 355-380, July.
    2. Petra Baji & Milena Pavlova & László Gulácsi & Miklós Farkas & Wim Groot, 2014. "The link between past informal payments and willingness of the Hungarian population to pay formal fees for health care services: results from a contingent valuation study," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 15(8), pages 853-867, November.
    3. Vincenzo Atella & Francesco D'Amico, 2010. "Who is responsible for your health: You, your doctor or new technologies?," CEIS Research Paper 167, Tor Vergata University, CEIS, revised 28 May 2010.
    4. Nour Yassin, 2022. "Adherence to Treatment in Diabetic Patients in Lebanon," Technium Social Sciences Journal, Technium Science, vol. 37(1), pages 375-395, November.
    5. Vincenzo Atella & Federico Belotti & Domenico Depalo, 2017. "Drug therapy adherence and health outcomes in the presence of physician and patient unobserved heterogeneity," Health Economics, John Wiley & Sons, Ltd., vol. 26(S2), pages 106-126, September.
    6. Mas, Nuria & Cirera, Laia & Viñolas, Guillem, 2011. "Los sistemas de copago en Europa, Estados Unidos y Canadá: Implicaciones para el caso español," IESE Research Papers D/939, IESE Business School.
    7. Jones, A.M, 2010. "Models For Health Care," Health, Econometrics and Data Group (HEDG) Working Papers 10/01, HEDG, c/o Department of Economics, University of York.
    8. Gourzoulidis, George & Kourlaba, Georgia & Stafylas, Panagiotis & Giamouzis, Gregory & Parissis, John & Maniadakis, Nikolaos, 2017. "Association between copayment, medication adherence and outcomes in the management of patients with diabetes and heart failure," Health Policy, Elsevier, vol. 121(4), pages 363-377.
    9. Vincenzo Atella & Joanna Kopinska, 2014. "The impact of cost-sharing schemes on drug compliance in Italy: evidence based on quantile regression," International Journal of Public Health, Springer;Swiss School of Public Health (SSPH+), vol. 59(2), pages 329-339, April.
    10. Jaume Puig-Junoy & Pilar Garcia-Gomez & David Casado-Marin, 2011. "Free Medicines thanks to Retirement: Moral Hazard and Hospitalization Offsets in an NHS," Tinbergen Institute Discussion Papers 11-108/3, Tinbergen Institute.
    11. Franco Peracchi & Claudio Rossetti, 2022. "A nonlinear dynamic factor model of health and medical treatment," Health Economics, John Wiley & Sons, Ltd., vol. 31(6), pages 1046-1066, June.
    12. Fiorio, Carlo V. & Siciliani, Luigi, 2010. "Co-payments and the demand for pharmaceuticals: Evidence from Italy," Economic Modelling, Elsevier, vol. 27(4), pages 835-841, July.
    13. Sarah-Jo Sinnott & Claire Buckley & David O′Riordan & Colin Bradley & Helen Whelton, 2013. "The Effect of Copayments for Prescriptions on Adherence to Prescription Medicines in Publicly Insured Populations; A Systematic Review and Meta-Analysis," PLOS ONE, Public Library of Science, vol. 8(5), pages 1-11, May.
    14. Astrid Kiil & Kurt Houlberg, 2014. "How does copayment for health care services affect demand, health and redistribution? A systematic review of the empirical evidence from 1990 to 2011," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 15(8), pages 813-828, November.
    15. Jaume Puig‐Junoy & Pilar García‐Gómez & David Casado‐Marín, 2016. "Free Medicines Thanks to Retirement: Impact of Coinsurance Exemption on Pharmaceutical Expenditures and Hospitalization Offsets in a national health service," Health Economics, John Wiley & Sons, Ltd., vol. 25(6), pages 750-767, June.
    16. 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.
    17. Marquez-Padilla, Fernanda, 2021. "When less is more: Can reduced health monitoring improve medication adherence?," Journal of Health Economics, Elsevier, vol. 75(C).
    18. Mario Martínez-Jiménez & Pilar García-Gómez & Jaume Puig-Junoy, 2021. "The Effect of Changes in Cost Sharing on the Consumption of Prescription and Over-the-Counter Medicines in Catalonia," IJERPH, MDPI, vol. 18(5), pages 1-21, March.
    19. Panagiotis Petrou, 2015. "An Interrupted Time-Series Analysis to Assess Impact of Introduction of Co-Payment on Emergency Room Visits in Cyprus," Applied Health Economics and Health Policy, Springer, vol. 13(5), pages 515-523, October.

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Vincenzo Atella & Peter R. Noyce & Ellen Schafheutle & Karen Hassell, 2005. "Affordability of Medicines and Patients' Cost Reduction Behaviors: Empirical Evidence Based on SUR Estimates from Italy and the United Kingdom," CEIS Research Paper 71, Tor Vergata University, CEIS.
    2. Sarma, Sisira & Basu, Kisalaya & Gupta, Anil, 2007. "The influence of prescription drug insurance on psychotropic and non-psychotropic drug utilization in Canada," Social Science & Medicine, Elsevier, vol. 65(12), pages 2553-2565, December.
    3. Noyce, Peter R. & Huttin, Christine & Atella, Vicenzo & Brenner, Gerhard & Haaijer-Ruskamp, Flora M. & Hedvall, Maj-Britt & Mechtler, Reli, 2000. "The cost of prescription medicines to patients," Health Policy, Elsevier, vol. 52(2), pages 129-145, June.
    4. Crown William H. & Berndt Ernst R. & Baser Onur & Finkelstein Stan N. & Witt Whitney P. & Maguire Jonathan & Haver Kenan E., 2004. "Benefit Plan Design and Prescription Drug Utilization Among Asthmatics: Do Patient Copayments Matter?," Forum for Health Economics & Policy, De Gruyter, vol. 7(1), pages 1-35, January.
    5. M. Fasihul Alam & David Cohen & Frank Dunstan & Dyfrig Hughes & Philip Routledge, 2018. "Impact of the phased abolition of co‐payments on the utilisation of selected prescription medicines in Wales," Health Economics, John Wiley & Sons, Ltd., vol. 27(1), pages 236-243, January.
    6. Paul Contoyannis & Jeremiah Hurley & Paul Grootendorst & Sung‐Hee Jeon & Robyn Tamblyn, 2005. "Estimating the price elasticity of expenditure for prescription drugs in the presence of non‐linear price schedules: an illustration from Quebec, Canada," Health Economics, John Wiley & Sons, Ltd., vol. 14(9), pages 909-923, September.
    7. Gianluca Baio & Laura Magazzini & Antonio Nicita & Fabio Pammolli & Massimo Riccaboni, 2003. "Il Decreto DL 15/04/2002, n. 63 sul Contenimento della Spesa Farmaceutica - Impatto sull'Industria e Distorsioni nel Funzionamento del Mercato," Working Papers CERM 0-2003, Competitività, Regole, Mercati (CERM).
    8. Vincenzo Atella & Joanna Kopinska, 2014. "The impact of cost-sharing schemes on drug compliance in Italy: evidence based on quantile regression," International Journal of Public Health, Springer;Swiss School of Public Health (SSPH+), vol. 59(2), pages 329-339, April.
    9. Doyle, Orla & Harmon, Colm P. & Walker, Ian, 2005. "The Impact of Parental Income and Education on the Health of their Children," IZA Discussion Papers 1832, Institute of Labor Economics (IZA).
    10. Zhao, Meng & Konishi, Yoshifumi & Glewwe, Paul, 2013. "Does information on health status lead to a healthier lifestyle? Evidence from China on the effect of hypertension diagnosis on food consumption," Journal of Health Economics, Elsevier, vol. 32(2), pages 367-385.
    11. Emma Verastegui & Alejandro Mohar, 2010. "Colorectal cancer in Mexico: should a middle income country invest in screening or in treatment?," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 10(1), pages 107-114, January.
    12. Jiménez-Rubio, Dolores & Hernández-Quevedo, Cristina, 2010. "Explaining the demand for pharmaceuticals in Spain: Are there differences in drug consumption between foreigners and the Spanish population?," Health Policy, Elsevier, vol. 97(2-3), pages 217-224, October.
    13. Morgan, Steve & McMahon, Meghan & Greyson, Devon, 2008. "Balancing health and industrial policy objectives in the pharmaceutical sector: Lessons from Australia," Health Policy, Elsevier, vol. 87(2), pages 133-145, August.
    14. Iain M. Cockburn & Jean O. Lanjouw & Mark Schankerman, 2016. "Patents and the Global Diffusion of New Drugs," American Economic Review, American Economic Association, vol. 106(1), pages 136-164, January.
    15. Antonio Cabrales, 2003. "Pharmaceutical generics, vertical product differentiation and public policy," Economics Working Papers 662, Department of Economics and Business, Universitat Pompeu Fabra.
    16. Ammas Siraj Mohammed & Nigist Alemayehu Woldekidan & Fuad Adem Mohammed, 2020. "Knowledge, attitude, and practice of pharmacy professionals on generic medicines in Eastern Ethiopia: A cross-sectional study," PLOS ONE, Public Library of Science, vol. 15(7), pages 1-12, July.
    17. Lambrelli D & O’Donnell O, 2009. "Why Does the Utilization of Pharmaceuticals Vary So Much Across Europe? Evidence from Micro Data on Older Europeans," Health, Econometrics and Data Group (HEDG) Working Papers 09/06, HEDG, c/o Department of Economics, University of York.
    18. Alan, Sule & Crossley, Thomas F. & Grootendorst, Paul & Veall, Michael R., 2002. "The effects of drug subsidies on out-of-pocket prescription drug expenditures by seniors: regional evidence from Canada," Journal of Health Economics, Elsevier, vol. 21(5), pages 805-826, September.
    19. Verniers, Isabel & Stremersch, Stefan & Croux, Christophe, 2011. "The global entry of new pharmaceuticals: A joint investigation of launch window and price," International Journal of Research in Marketing, Elsevier, vol. 28(4), pages 295-308.
    20. Li, M. & Ohkusa, Y., 2000. "An Empirical Research of Substitutability between Medical Services and Over-the-Counter Medication. An Analysis of Thirteen Different Minor Ailments," ISER Discussion Paper 0522, Institute of Social and Economic Research, Osaka University.

    More about this item

    Statistics

    Access and download statistics

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:wly:hlthec:v:15:y:2006:i:9:p:875-892. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: Wiley Content Delivery (email available below). General contact details of provider: http://www3.interscience.wiley.com/cgi-bin/jhome/5749 .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.