TABLE OF CONTENTS
1. Introduction *
1.1 Statins and Coronary Heart Disease *
1.2 Organization *
2. Literature on the Demand for Prescription Drugs *
2.1 Prescription Drug Utilization *
2.2 Prescription Drug Price Elasticity *
3. Coronary Heart Disease & Statins *
3.1 Serum Cholesterol and CHD Risk *
3.2 Clinical Efficacy of Statins *
3.2.1 Statins Effectively Reduce Risk for CHD *
3.2.2 Comparative Efficacy of Statins in Modifying Cholesterol *
3.2.3 Side Effect Profiles of the Statins *
4. Economic Differentiation of Statins *
4.1. Pricing *
4.2. Advertising *
4.3. Cost-Effectiveness *
5. The Structure of Demand for Prescription Drugs *
5.1 The Doctor-Patient Relationship *
5.2 The Structure of Managed Insurance Drug Benefits *
5.3 Patient Selection into Plans with Favorable Drug Coverage *
6. The Economics of Drug Demand *
6.1 Probabilistic Consumer Theory *
6.2 The Random Utility Maximization Hypothesis *
6.3 Aggregation of Preferences *
7. Econometric Specification of Prescription Drug Choice *
8. Data *
8.1 Final Sample of Patients *
8.2 Concerns with Retrospective Data *
8.3 Analytical Variables *
8.3.1 Statin of Choice *
8.3.2 Statin Copayment *
8.3.3 Insurance Type *
8.3.4 Demographic Variables *
8.3.5 Patient Health Status *
8.3.6 Medical Utilization *
8.3.7 Concurrent Lipid-Lowering Medication *
9. Descriptive Statistics *
9.1 Statin Treatment *
9.2 Statin Copayments *
9.3 Insurance Type *
9.4 Demographic Variables *
9.5 Patient Health Status *
9.6 Medical Utilization *
9.7 Concurrent Lipid-Lowering Medication *
10. Multivariate Regression Results *
10.1 Relative Copayments Influence Choice of a Statin *
10.2 Insurers Affect Choice via Non-price Methods *
10.3 Age, Gender and Region *
10.4 Strong Association between Choice and Health Status *
10.5 Summary of Main Multivariate Results *
11. Multivariate Sensitivity Analyses *
11.1 Patient’s CHD Status *
11.2 Copayment Estimation *
11.2.1 Averaging Copayments on a Monthly Basis *
11.2.2 Visual Inspection of Copayments *
11.3 Independence from Irrelevant Alternatives *
12. Extensions *
12.1 A Physician’s Point-of-View *
12.2 To Switch or Not to Switch? *
12.3 Panel Data Approach to Prescription Drug Demand *
13. Discussion of Policy Implications & Conclusion *
13.1 Bargaining in the Prescription Drug Market *
13.2 A Medicare Prescription Drug Benefit *
13.3 Conclusion *
References *
Appendix A: Statin National Drug Codes *
Appendix B: The Charlson Comorbidity Index *
Appendix C: Main Multivariate Regression Results *
Appendix D: ICD-9 Codes of Interest *
Appendix E: Multivariate Results--Health Status *
Appendix F: Multivariate Results--Copayment Estimation *
Appendix G: Mathematical Exposition from Chapter 6 *
Choice Probability Assumptions *
Assumptions imposed on *
The Direct Utility Assumption *
Properties of Indirect Utility *
Biography
Domenico Esposito
