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The impact of cost sharing schemes on drug compliance: evidence based on quantile regression

In this work we investigate the causal impact of cost sharing schemes on drug compliance using a Difference-in-Differences approach within a quantile regression framework. We exploit a series of natural experiments occurred in Italy between 2000 and 2010, referring to the introduction of regional co-payment schemes. We find that co-payments have a negative impact on compliance, causing a reallocation of individuals from the upper to the lower tail of the compliance distribution, thus hurting the already narrow group of good compliers. The empirical evidence suggests also that gender, clinical history and geographic residence are important drivers of compliance, particularly within the group of poor compliers.

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Paper provided by Tor Vergata University, CEIS in its series CEIS Research Paper with number 247.

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Length: 28 pages
Date of creation: 27 Jul 2012
Date of revision: 27 Jul 2012
Handle: RePEc:rtv:ceisrp:247
Contact details of provider: Postal: CEIS - Centre for Economic and International Studies - Faculty of Economics - University of Rome "Tor Vergata" - Via Columbia, 2 00133 Roma
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Order Information: Postal: CEIS - Centre for Economic and International Studies - Faculty of Economics - University of Rome "Tor Vergata" - Via Columbia, 2 00133 Roma
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  1. Tullio Jappelli & Luigi Pistaferri & Guglielmo Weber, 2006. "Health Care Quality, Economic Inequality, and Precautionary Saving," "Marco Fanno" Working Papers 0020, Dipartimento di Scienze Economiche "Marco Fanno".
  2. 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.
  3. Vincenzo Atella & Ellen Schafheutle & Peter Noyce & Karen Hassell, 2005. "Affordability of Medicines and Patients' Cost-Reducing Behaviour: Empirical Evidence Based on SUR Estimates from Italy and the UK," Applied Health Economics and Health Policy, Springer Healthcare | Adis, vol. 4(1), pages 23-35.
  4. Koenker, Roger W & Bassett, Gilbert, Jr, 1978. "Regression Quantiles," Econometrica, Econometric Society, vol. 46(1), pages 33-50, January.
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