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Customization in prescribing for bipolar disorder

Author

Listed:
  • Dominic Hodgkin
  • Joanna Volpe‐Vartanian
  • Elizabeth L. Merrick
  • Constance M. Horgan
  • Andrew A. Nierenberg
  • Richard G. Frank
  • Sue Lee

Abstract

For many disorders, patient heterogeneity requires physicians to customize their treatment to each patient's needs. We test for the existence of customization in physicians' prescribing for bipolar disorder, using data from a naturalistic clinical effectiveness trial of bipolar disorder treatment (STEP‐BD), which did not constrain physician prescribing. Multinomial logit is used to model the physician's choice among five combinations of drug classes. We find that our observed measure of the patient's clinical status played only a limited role in the choice among drug class combinations, even for conditions such as mania that are expected to affect class choice. However, treatment of a patient with given characteristics differed widely depending on which physician was seen. The explanatory power of the model was low. There was variation within each physician's prescribing, but the results do not suggest a high degree of customization in physicians' prescribing, based on our measure of clinical status. Copyright © 2011 John Wiley & Sons, Ltd.

Suggested Citation

  • Dominic Hodgkin & Joanna Volpe‐Vartanian & Elizabeth L. Merrick & Constance M. Horgan & Andrew A. Nierenberg & Richard G. Frank & Sue Lee, 2012. "Customization in prescribing for bipolar disorder," Health Economics, John Wiley & Sons, Ltd., vol. 21(6), pages 653-668, June.
    • Handle: RePEc:wly:hlthec:v:21:y:2012:i:6:p:653-668
    DOI: 10.1002/hec.1737
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    References listed on IDEAS

    as
    1. Hausman, Jerry & McFadden, Daniel, 1984. "Specification Tests for the Multinomial Logit Model," Econometrica, Econometric Society, vol. 52(5), pages 1219-1240, September.
    2. Anirban Basu & David Meltzer, 2007. "Value of Information on Preference Heterogeneity and Individualized Care," Medical Decision Making, , vol. 27(2), pages 112-127, March.
    3. Frank, Richard G. & Zeckhauser, Richard J., 2007. "Custom-made versus ready-to-wear treatments: Behavioral propensities in physicians' choices," Journal of Health Economics, Elsevier, vol. 26(6), pages 1101-1127, December.
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    1. Emily L. Butler & Eric B. Laber & Sonia M. Davis & Michael R. Kosorok, 2018. "Incorporating Patient Preferences into Estimation of Optimal Individualized Treatment Rules," Biometrics, The International Biometric Society, vol. 74(1), pages 18-26, March.

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