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

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  • 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.

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  • 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
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    Cited by:

    1. 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.
    2. 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.
    3. 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.
    4. 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.
    5. 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.
    6. Nour Yassin, 2022. "Adherence to Treatment in Diabetic Patients in Lebanon," Technium Social Sciences Journal, Technium Science, vol. 37(1), pages 375-395, November.
    7. 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.
    8. 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.
    9. 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.
    10. Vanessa Cirulli & Giuliano Resce & Marco Ventura, 2021. "Co-payment exemption and healthcare consumption. Quasi-experimental evidence from Italy," Working Papers in Public Economics 203, University of Rome La Sapienza, Department of Economics and Law.
    11. 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.
    12. 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.
    13. 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.
    14. 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.
    15. Marquez-Padilla, Fernanda, 2021. "When less is more: Can reduced health monitoring improve medication adherence?," Journal of Health Economics, Elsevier, vol. 75(C).
    16. 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.
    17. 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.
    18. 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.
    19. 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.

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