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

  • Vincenzo Atella

    (Faculty of Economics, University of Rome 'Tor Vergata', Rome, Italy)

  • Franco Peracchi

    (Faculty of Economics, University of Rome 'Tor Vergata', Rome, Italy)

  • Domenico Depalo

    (Faculty of Economics, University of Rome 'Tor Vergata', Rome, Italy)

  • Claudio Rossetti

    (Faculty of Economics, University of Rome 'Tor Vergata', Rome, Italy)

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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File URL: http://hdl.handle.net/10.1002/hec.1135
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Article provided by John Wiley & Sons, Ltd. in its journal Health Economics.

Volume (Year): 15 (2006)
Issue (Month): 9 ()
Pages: 875-892

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Handle: RePEc:wly:hlthec:v:15:y:2006:i:9:p:875-892
Contact details of provider: Web page: http://www3.interscience.wiley.com/cgi-bin/jhome/5749

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  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. 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.
  3. 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.
  4. Stéphane Jacobzone, 2000. "Pharmaceutical Policies in OECD Countries: Reconciling Social and Industrial Goals," OECD Labour Market and Social Policy Occasional Papers 40, OECD Publishing.
  5. Anne Case & Ingrid le Roux & Alicia Menendez, 2004. "Medical Compliance and Income-Health Gradients," Working Papers 174, Princeton University, Woodrow Wilson School of Public and International Affairs, Research Program in Development Studies..
  6. 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.
  7. 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.
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