The Heterogeneity of Concentrated Prescribing Behavior Theory and Evidence from Antipsychotics
➤ Gửi thông báo lỗi ⚠️ Báo cáo tài liệu vi phạmNội dung chi tiết: The Heterogeneity of Concentrated Prescribing Behavior Theory and Evidence from Antipsychotics
The Heterogeneity of Concentrated Prescribing Behavior Theory and Evidence from Antipsychotics
https://khothuvien.cori!The Heterogeneity of Concentrated Prescribing Behavior: Theory and Evidence from Antipsychoticsby Anna Levine Taub1, Anton Kol The Heterogeneity of Concentrated Prescribing Behavior Theory and Evidence from Antipsychoticslotilin1, Robert s. Gibbons', and Ernst R. Berndt4AbstractPhysicians prescribing drugs for patients with schizophrenia and related conditions are remarkably concentrated in their choice among ten older typical and six newer atypical antipsychotic drugs. In 2007 the single antipsychotic drug most pre The Heterogeneity of Concentrated Prescribing Behavior Theory and Evidence from Antipsychoticsscribed by an average physician accounted for 59% of all antipsychotic prescriptions written by that physician. Moreover, among physicians who concentThe Heterogeneity of Concentrated Prescribing Behavior Theory and Evidence from Antipsychotics
rate their prescriptions on one or a few drugs, different physicians concentrate on different drugs. We construct a model of physician learning-by-doihttps://khothuvien.cori!The Heterogeneity of Concentrated Prescribing Behavior: Theory and Evidence from Antipsychoticsby Anna Levine Taub1, Anton Kol The Heterogeneity of Concentrated Prescribing Behavior Theory and Evidence from Antipsychoticsians, we examine these predictions empirically. While prescribing behavior is generally quite concentrated, we find that, consistent with our model, prescribers having greater prescription volumes tend to have less concentrated prescribing patterns. Our model outperforms a competing theory concernin The Heterogeneity of Concentrated Prescribing Behavior Theory and Evidence from Antipsychoticsg detailing by pharmaceutical representatives, and we provide a new correction for the mechanical bias present in other estimators used in the literatThe Heterogeneity of Concentrated Prescribing Behavior Theory and Evidence from Antipsychotics
ure.JEL Classification: 110: 111: D80: D83Keywords: Antipsychotic, pharmaceutical, concentration, learning, prescription, physician'Cornerstone Researhttps://khothuvien.cori!The Heterogeneity of Concentrated Prescribing Behavior: Theory and Evidence from Antipsychoticsby Anna Levine Taub1, Anton Kol The Heterogeneity of Concentrated Prescribing Behavior Theory and Evidence from Antipsychotics Bưeau of Economic Research•This research has benefited enormously from the IMS Health Services Research Network that has provided data and data assistance. Special thanks are due to Stu Feldman. Randolph Frankel. Ody Halas. Robert Hunger and Linda Matusiak at IMS Health. We have also benefited from The Heterogeneity of Concentrated Prescribing Behavior Theory and Evidence from Antipsychotics feedback try seminar participants at Wharton. Northeastern University. Boston University School of Public Health, the NBER. the university of ChicagoThe Heterogeneity of Concentrated Prescribing Behavior Theory and Evidence from Antipsychotics
. and the University of California - Los Angeles, and from the comments of Joseph Doyle. Marcela Horvitz-Lennon. Uirike Malmendier. David Molitor. Jonhttps://khothuvien.cori!The Heterogeneity of Concentrated Prescribing Behavior: Theory and Evidence from Antipsychoticsby Anna Levine Taub1, Anton Kol The Heterogeneity of Concentrated Prescribing Behavior Theory and Evidence from Antipsychoticscript are based in part on 1996-2008 data obtained under license from IMS Health Incorporated: National Prescription Audit-”, Xpcnent-” and American Medical Association Physician Masterfile-”. All rights reserved. Such statements, findings.conclusions, views and opinions are not necessarily those of The Heterogeneity of Concentrated Prescribing Behavior Theory and Evidence from Antipsychotics IMS Health Incorporated or any of its affiliated or subsidiary entitles. This research has not been sponsored.Document Name: Heterogeneity VdB docx DThe Heterogeneity of Concentrated Prescribing Behavior Theory and Evidence from Antipsychotics
ate: Ncrrember 12.2012Heterogeneous Concentration of Physician Prescribing Behavior1. INTRODUCTION1.1 MOTIVATION AND OVERVIEWConsider a physician seeihttps://khothuvien.cori!The Heterogeneity of Concentrated Prescribing Behavior: Theory and Evidence from Antipsychoticsby Anna Levine Taub1, Anton Kol The Heterogeneity of Concentrated Prescribing Behavior Theory and Evidence from Antipsychoticsce, patient response to a given treatment is idiosyncratic and unpredictable in terms of both efficacy and side effects. What treatment algorithms might the physician employ to learn about the efficacy and tolerability of the alternative drug therapies for this and future similar patients?One possib The Heterogeneity of Concentrated Prescribing Behavior Theory and Evidence from Antipsychoticsility is for the physician to concentrate her prescribing behavior—in the extreme, on just one drug. By observing this and future patients' responsesThe Heterogeneity of Concentrated Prescribing Behavior Theory and Evidence from Antipsychotics
to that drug, the physician can learn by doing, thereafter exploiting her accumulated knowledge about this drug. For example, the physician will learnhttps://khothuvien.cori!The Heterogeneity of Concentrated Prescribing Behavior: Theory and Evidence from Antipsychoticsby Anna Levine Taub1, Anton Kol The Heterogeneity of Concentrated Prescribing Behavior Theory and Evidence from Antipsychotics day to take the drug: in addition, she will learn how to adjust the dosage depending on patients’ factors such as smoking behavior, thereby improving patient outcomes and engaging the patient in adherence and symptom remission.Alternatively, the physician might diversify her prescriptions across se The Heterogeneity of Concentrated Prescribing Behavior Theory and Evidence from Antipsychoticsveral drugs, hoping to find the best match between different drugs and current and future similar patients, specifically, based on information from aThe Heterogeneity of Concentrated Prescribing Behavior Theory and Evidence from Antipsychotics
patient’s history, familiarity with the existing scientific and clinical literature, conversations with fellow medical professionals in the local and https://khothuvien.cori!The Heterogeneity of Concentrated Prescribing Behavior: Theory and Evidence from Antipsychoticsby Anna Levine Taub1, Anton Kol The Heterogeneity of Concentrated Prescribing Behavior Theory and Evidence from Antipsychoticsi appears to be the best match with the particular patient's characteristics (even if the physician is less able to counsel the patient on the side effects, interactions, and other aspects of the drug).In short, the physician can learn from exploiting or exploring, concentrating or diversifying. Phy The Heterogeneity of Concentrated Prescribing Behavior Theory and Evidence from Antipsychoticssicians continually face this tradeoff as they treat patients and invest in learning about available2Heterogeneous Concentration of Physician PrescribThe Heterogeneity of Concentrated Prescribing Behavior Theory and Evidence from Antipsychotics
ing Behaviortreatments. In this paper, we develop and test a model of physician learning by doing that addresses these issues.Our theory predicts how https://khothuvien.cori!The Heterogeneity of Concentrated Prescribing Behavior: Theory and Evidence from Antipsychoticsby Anna Levine Taub1, Anton Kol The Heterogeneity of Concentrated Prescribing Behavior Theory and Evidence from Antipsychoticsl converge (exhibiting near unanimity on the choice of a favorite drug) or diverge (with different physicians concentrating on different drugs). Our model predicts that path-dependence in learning by doing is a strong force towards the latter. In addition, our model predicts how different young phys The Heterogeneity of Concentrated Prescribing Behavior Theory and Evidence from Antipsychoticsicians will utilize older (‘off label") drugs. Finally, we use our model to guide our econometric specification.We confront our model with data on a pThe Heterogeneity of Concentrated Prescribing Behavior Theory and Evidence from Antipsychotics
articular therapeutic class of drugs known as antipsychotics. Later in this Introduction, we provide a brief background on the history of antipsychotihttps://khothuvien.cori!The Heterogeneity of Concentrated Prescribing Behavior: Theory and Evidence from Antipsychoticsby Anna Levine Taub1, Anton Kol The Heterogeneity of Concentrated Prescribing Behavior Theory and Evidence from Antipsychoticsfocuses disproportionately on one drug, but there is substantial heterogeneity across prescribers concerning their most-used drug.These initial findings on heterogeneous concentration are consistent with our theoretical framework (emphasizing path dependence in learning by doing), from which \'Je ad The Heterogeneity of Concentrated Prescribing Behavior Theory and Evidence from Antipsychoticsvance several novel hypotheses. We then discuss the data and econometric framework, including a new correction for the mechanical bias present in otheThe Heterogeneity of Concentrated Prescribing Behavior Theory and Evidence from Antipsychotics
r estimators used in the literature, and present a substantial set of empirical findings that broadly accord with our model. We conclude by explaininghttps://khothuvien.cori!The Heterogeneity of Concentrated Prescribing Behavior: Theory and Evidence from Antipsychoticsby Anna Levine Taub1, Anton Kol The Heterogeneity of Concentrated Prescribing Behavior Theory and Evidence from Antipsychoticsiation literature, and suggesting directions for future research.The issues in this paper are important: understanding factors affecting physicians’ choices along the concentration-diversification continuum has significant commercial and public health implications, particularly in the current contex The Heterogeneity of Concentrated Prescribing Behavior Theory and Evidence from Antipsychoticst of promoting both the evidence-based and “personalized" practice of medicine. Perhaps not surprisingly, therefore, some of the issues we explore havThe Heterogeneity of Concentrated Prescribing Behavior Theory and Evidence from Antipsychotics
e been discussed by3Heterogeneous Concentration of Physician Prescribing Behaviorothers. For example. Coscelli (2000), Coscelli and Shum (2004), and Fhttps://khothuvien.cori!The Heterogeneity of Concentrated Prescribing Behavior: Theory and Evidence from Antipsychoticsby Anna Levine Taub1, Anton Kol The Heterogeneity of Concentrated Prescribing Behavior Theory and Evidence from Antipsychoticsthat would be inconsistent with several of our findings, and Frank and Zeckhauser offer a very different model that again does not tít with some of our results.1 Turning from physicians to patients. Crawford and Shum (2005) and Dickstein (2012) have studied a problem complementary to ours: how a giv The Heterogeneity of Concentrated Prescribing Behavior Theory and Evidence from Antipsychoticsen patient's treatment regime evolves over time. In short, our model studies learning across patients, whereas these latter models study learning withThe Heterogeneity of Concentrated Prescribing Behavior Theory and Evidence from Antipsychotics
in patients. We can imagine interesting and testable implications from combining the two. and we hope that future work will pursue such possibilities.https://khothuvien.cori!The Heterogeneity of Concentrated Prescribing Behavior: Theory and Evidence from Antipsychoticsby Anna Levine Taub1, Anton Kol The Heterogeneity of Concentrated Prescribing Behavior Theory and Evidence from Antipsychoticsgs in empirical analyses like ours. The overwhelming finding from this literature, with contributions both by health economists (e.g.. Hellerstein (1998) and Zhang, Baicker, and Newhouse (2010)) and academic clinicians (e.g., Solomon et. al (2003) and Schneeweis et. al. (2005)), is that the estimate The Heterogeneity of Concentrated Prescribing Behavior Theory and Evidence from Antipsychoticsd role of physicians in influencing treatment regimes is largely unaffected by incorporating patient-specific data. For example, the results obtainedThe Heterogeneity of Concentrated Prescribing Behavior Theory and Evidence from Antipsychotics
by Frank and Zeckhauser (2007) suggest that, other than through demographics, variations in patient condition severity and clinical manifestations areGọi ngay
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