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Determinants of US Prescription Drug Utilization using County Level Data

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  • Thierry Nianogo
  • Albert Okunade
  • Demba Fofana
  • Weiwei Chen

Abstract

Prescription drugs are the third largest component of US healthcare expenditures. The 2006 Medicare Part D and the 2010 Affordable Care Act are catalysts for further growths in utilization becuase of insurance expansion effects. This research investigating the determinants of prescription drug utilization is timely, methodologically novel, and policy relevant. Differences in population health status, access to care, socioeconomics, demographics, and variations in per capita number of scripts filled at retail pharmacies across the USA justify fitting separate econometric models to county data of the states partitioned into low, medium, and high prescription drug users. Given the skewed distribution of per capita number of filled prescriptions (response variable), we fit the variance stabilizing Box–Cox power transformation regression models to 2011 county level data for investigating the correlates of prescription drug utilization separately for low, medium, and high utilization states. Maximum likelihood regression parameter estimates, including the optimal Box–Cox λ power transformations, differ across high (λ = 0.214), medium (λ = 0.942), and low (λ = 0.302) prescription drug utilization models. The estimated income elasticities of −0.634, 0.031, and −0.532 in high, medium, and low utilization models suggest that the economic behavior of prescriptions is not invariant across different utilization levels. Copyright © 2015 John Wiley & Sons, Ltd.

Suggested Citation

  • Thierry Nianogo & Albert Okunade & Demba Fofana & Weiwei Chen, 2016. "Determinants of US Prescription Drug Utilization using County Level Data," Health Economics, John Wiley & Sons, Ltd., vol. 25(5), pages 606-619, May.
  • Handle: RePEc:wly:hlthec:v:25:y:2016:i:5:p:606-619
    DOI: 10.1002/hec.3176
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    References listed on IDEAS

    as
    1. Okunade, Albert A. & Suraratdecha, Chutima, 2006. "The pervasiveness of pharmaceutical expenditure inertia in the OECD countries," Social Science & Medicine, Elsevier, vol. 63(1), pages 225-238, July.
    2. Tomas J. Philipson & Seth A. Seabury & Lee M. Lockwood & Dana P. Goldman & Darius N. Lakdawalla, 2010. "Geographic Variation in Health Care: The Role of Private Markets," Brookings Papers on Economic Activity, Economic Studies Program, The Brookings Institution, vol. 41(1 (Spring), pages 325-361.
    3. Daron Acemoglu & Amy Finkelstein & Matthew J. Notowidigdo, 2013. "Income and Health Spending: Evidence from Oil Price Shocks," The Review of Economics and Statistics, MIT Press, vol. 95(4), pages 1079-1095, October.
    4. Marin C. Gemmill & Joan Costa‐Font & Alistair McGuire, 2007. "In search of a corrected prescription drug Elasticity estimate: a meta‐regression approach," Health Economics, John Wiley & Sons, Ltd., vol. 16(6), pages 627-643, June.
    5. William Encinosa & Didem Bernard & Avi Dor, 2010. "Does Prescription Drug Adherence Reduce Hospitalizations and Costs?," NBER Working Papers 15691, National Bureau of Economic Research, Inc.
    6. Pierre‐Yves Crémieux & Marie‐Claude Meilleur & Pierre Ouellette & Patrick Petit & Martin Zelder & Ken Potvin, 2005. "Public and private pharmaceutical spending as determinants of health outcomes in Canada," Health Economics, John Wiley & Sons, Ltd., vol. 14(2), pages 107-116, February.
    7. repec:adr:anecst:y:2005:i:79-80:p:25 is not listed on IDEAS
    8. Lee Branstetter & Chirantan Chatterjee & Matthew J. Higgins, 2014. "Generic Competition and the Incentives for Early-Stage Pharmaceutical Innovation," NBER Working Papers 20532, National Bureau of Economic Research, Inc.
    9. Weiwei Chen & Albert Okunade & Gregory G. Lubiani, 2014. "Quality–Quantity Decomposition Of Income Elasticity Of U.S. Hospital Care Expenditure Using State‐Level Panel Data," Health Economics, John Wiley & Sons, Ltd., vol. 23(11), pages 1340-1352, November.
    10. Lichtenberg, Frank R. & Tatar, Mehtap & Çalışkan, Zafer, 2014. "The effect of pharmaceutical innovation on longevity, hospitalization and medical expenditure in Turkey, 1999–2010," Health Policy, Elsevier, vol. 117(3), pages 361-373.
    11. Steven T. Yen & Andrew M. Jones, 1996. "Individual cigarette consumption and addiction: A flexible limited dependent variable approach," Health Economics, John Wiley & Sons, Ltd., vol. 5(2), pages 105-117, March.
    12. Paul V. Grootendorst, 1995. "A comparison of alternative models of prescription drug utilization," Health Economics, John Wiley & Sons, Ltd., vol. 4(3), pages 183-198, May.
    13. Pierre-Yves Crémieux & Pierre Ouellette & Patrick Petit, 2007. "Do Drugs Reduce Utilisation of Other Healthcare Resources?," PharmacoEconomics, Springer, vol. 25(3), pages 209-221, March.
    14. Lichtenberg, Frank R, 1996. "Do (More and Better) Drugs Keep People Out of Hospitals?," American Economic Review, American Economic Association, vol. 86(2), pages 384-388, May.
    15. Murray L. Aitken & Ernst R. Berndt & Barry Bosworth & Iain M. Cockburn & Richard Frank & Michael Kleinrock & Bradley T. Shapiro, 2013. "The Regulation of Prescription Drug Competition and Market Responses: Patterns in Prices and Sales following Loss of Exclusivity," NBER Chapters, in: Measuring and Modeling Health Care Costs, pages 243-271, National Bureau of Economic Research, Inc.
    16. Marc Saez & Carles Murillo, 1994. "Shared ‘features’ in prices: Income and price elasticities for health care expenditures," Health Economics, John Wiley & Sons, Ltd., vol. 3(4), pages 267-279, July.
    17. Howard Tuckman & Cyril Chang & Albert Okunade, 1999. "A transform-both-sides modulus power model: an application in health care," Applied Economics Letters, Taylor & Francis Journals, vol. 6(11), pages 741-745.
    18. John R. Moran & JKosali Ilayperuma Simon, 2006. "Income and the Use of Prescription Drugs by the Elderly: Evidence from the Notch Cohorts," Journal of Human Resources, University of Wisconsin Press, vol. 41(2).
    19. Okunade, Albert A & Haryanto, H & Means, Dwight B, Jr, 1996. "Testing the Unbiasedness Hypothesis of Foreign Exchange Rates and the Analysis of Transformations," Review of Quantitative Finance and Accounting, Springer, vol. 6(1), pages 39-46, January.
    20. Adriana Lleras-Muney & Frank R. Lichtenberg, 2010. "Are the More Educated More Likely to Use New Drugs?," NBER Chapters, in: Contributions in Memory of Zvi Griliches, pages 671-696, National Bureau of Economic Research, Inc.
    21. Benzeval, Michaela & Judge, Ken, 2001. "Income and health: the time dimension," Social Science & Medicine, Elsevier, vol. 52(9), pages 1371-1390, May.
    22. Cutler, David M. & Lleras-Muney, Adriana, 2010. "Understanding differences in health behaviors by education," Journal of Health Economics, Elsevier, vol. 29(1), pages 1-28, January.
    23. David Granlund & Niklas Rudholm, 2012. "The Prescribing Physician’s Influence on Consumer Choice Between Medically Equivalent Pharmaceuticals," Review of Industrial Organization, Springer;The Industrial Organization Society, vol. 41(3), pages 207-222, November.
    24. repec:mpr:mprres:3919 is not listed on IDEAS
    25. Donald Vandegrift & Anusua Datta, 2006. "Prescription Drug Expenditures in the United States: The Effects of Obesity, Demographics, and New Pharmaceutical Products," Southern Economic Journal, John Wiley & Sons, vol. 73(2), pages 515-529, October.
    26. Mueller, C. & Schur, C. & O'Connell, J., 1997. "Prescription drug spending: The impact of age and chronic disease status," American Journal of Public Health, American Public Health Association, vol. 87(10), pages 1626-1629.
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