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Drug therapy adherence and health outcomes in the presence of physician and patient unobserved heterogeneity

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  • Vincenzo Atella
  • Federico Belotti
  • Domenico Depalo

Abstract

Understanding the role that drug adherence has on health outcomes in everyday clinical practice is central for the policy maker. This is particularly true when patients suffer from asymptomatic chronic conditions (e.g., hypertension, hypercholesterolaemia, and diabetes). By exploiting a unique longitudinal dataset at patient and physician level in Italy, we show that patients and physicians unobserved characteristics play an important role in determining health status, at least as important as drug adherence. Most importantly, we find that both adherence and prescribed treatment regimen effects are highly heterogeneous across physicians, highlighting their crucial role in shaping patients' health status.

Suggested Citation

  • 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.
    • Handle: RePEc:wly:hlthec:v:26:y:2017:i:s2:p:106-126
    DOI: 10.1002/hec.3570
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    Citations

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    Cited by:

    1. Domenico Depalo, 2020. "Explaining the causal effect of adherence to medication on cholesterol through the marginal patient," Health Economics, John Wiley & Sons, Ltd., vol. 29(S1), pages 110-126, October.
    2. Katharina E. Blankart & Friederike Arndt, 2020. "Physician-Level Cost Control Measures and Regional Variation of Biosimilar Utilization in Germany," IJERPH, MDPI, vol. 17(11), pages 1-14, June.
    3. Katharina E. Blankart & Frank R. Lichtenberg, 2020. "Are patients more adherent to newer drugs?," Health Care Management Science, Springer, vol. 23(4), pages 605-618, December.
    4. Federico Belotti & Joanna Kopinska & Alessandro Palma & Andrea Piano Mortari, 2022. "Health status and the Great Recession. Evidence from electronic health records," Health Economics, John Wiley & Sons, Ltd., vol. 31(8), pages 1770-1799, August.
    5. Joan Costa‐Font & Rosella Levaggi, 2020. "Innovation, aging, and health care: Unraveling “silver” from “red” herrings?," Health Economics, John Wiley & Sons, Ltd., vol. 29(S1), pages 3-7, October.
    6. Domenico Depalo & Jay Bhattacharya & Vincenzo Atella & Federico Belotti, 2019. "When Technological Advance Meets Physician Learning in Drug Prescribing," NBER Working Papers 26202, National Bureau of Economic Research, Inc.
    7. Di Novi, Cinzia & Leporatti, Lucia & Levaggi, Rosella & Montefiori, Marcello, 2022. "Adherence during COVID-19: The role of aging and socio-economics status in shaping drug utilization," Journal of Economic Behavior & Organization, Elsevier, vol. 204(C), pages 1-14.
    8. Cinzia Di Novi & Lucia Leporatti & Marcello Montefiori, 2020. "Older patients and geographic barriers to pharmacy access: When nonadherence translates to an increased use of other components of health care," Health Economics, John Wiley & Sons, Ltd., vol. 29(S1), pages 97-109, October.
    9. Lucia Leporatti & Rosella Levaggi & Marcello Montefiori, 2021. "Beyond price: the effects of non-financial barriers on access to drugs and health outcomes," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 22(4), pages 519-529, June.
    10. Atella, Vincenzo & Belotti, Federico & Giaccherini, Matilde & Medea, Gerardo & Nicolucci, Antonio & Sbraccia, Paolo & Mortari, Andrea Piano, 2024. "Lifetime costs of overweight and obesity in Italy," Economics & Human Biology, Elsevier, vol. 53(C).

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    JEL classification:

    • I12 - Health, Education, and Welfare - - Health - - - Health Behavior
    • O33 - Economic Development, Innovation, Technological Change, and Growth - - Innovation; Research and Development; Technological Change; Intellectual Property Rights - - - Technological Change: Choices and Consequences; Diffusion Processes
    • C23 - Mathematical and Quantitative Methods - - Single Equation Models; Single Variables - - - Models with Panel Data; Spatio-temporal Models

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