|dc.description.abstract||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
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.
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.||en_US