This Is AuburnElectronic Theses and Dissertations

Evaluating the Impact of Cost, Perceived Benefit and Perceived Value on Prescription Drug Purchasing Behavior




Fuldeore, Mahesh

Type of Degree



Pharmacy Care Systems


Many third party payers have implemented increased cost-sharing as a cost containment strategy. Previous studies suggest that this may reduce health care costs by reducing prescription drug expenditures. However, such strategies may increase total healthcare costs through increased non-adherence to treatment regimens. It is important to understand the factors influence patients’ decisions to purchase medications in order to formulate effective cost containment strategies that minimize the negative impact on medication compliance. According to consumer behavior theory, one’s response to increased cost is based on the perceived benefit of and perceived value derived from the product. previous work aimed at analyzing the impact of cost sharing has not analyzed the role of perceived benefit and perceived value in the decision making process. iv The purpose of this study was to 1) evaluate the relationship among cost, perceived benefit, perceived value and quantity of medication purchased, and 2) identify the major predictors of quantity of medication purchased. Patients new to statin therapy were identified from the prescription database of a national retail chain. The quantity of medications purchased during the first 12 months of statin therapy was measured in terms of the Medication Possession Ratio (MPR). Information not obtained from retail chain database was collected through patient surveys. A total of 181 patients were included in the final analysis. Structural equation modeling (SEM) demonstrated relationships among cost, perceived benefit, perceived value and MPR. Except for the direct relationship between perceived benefit and quantity of medications purchased, all the hypotheses were statistically significant. As expected, perceived value and MPR were positively impacted by perceived benefit and negatively impact by the cost paid by the patient. Perceived value had a positive impact on MPR. A CHAID (Chi-square automatic interaction detection) analysis identified five variables; cost, perceived benefit, perceived barrier, perceived value and perceived importance of taking medications as the most significant predictors of MPR. This study demonstrated that the individual’s response to higher cost sharing is not uniform across the population and it mainly influenced by individuals’ perception of perceived benefit and perceived value of the treatment. Results also emphasized that the patient population can be segmented in different segments, based on which variable is most critical to their decision making. Decision makers can identify such individuals and formulate customized compliance improvement strategies.