Heterogeneity in Drug Recommendation Compliance: The case for Alzheimer’s disease in France.

Summary Objectives: This study examines prescribers’ compliance with the 2011 clinical recommendation of the French National Authority for Health (HAS) aiming to limit the use of drugs specific to Alzheimer’s Disease (AD), and whether prescribers’ compliance differs as a function of patient gender. Study design: The sample consisted of quarterly data from the National Health Insurance claims database from 2010 to 2013 (16 quarters) for individuals living in the community, aged 65 or over at baseline. Methods: The probability of consuming AD drugs was estimated using a fixed effects model to account for individual and unobserved heterogeneity. Time-varying covariates were included to control for changes in health status and insurance effects. Estimations were carried out for men and women separately. Results: Discrepancies in trend of the probability of consuming AD drugs between women and men after the HAS’ 2011 recommendation were observed: the probability decreased for women while it remained constant for men. Conclusions: Our case study complements the literature on the influence of clinical recommendations by HTA body on clinical practices. Public health policies should take into account sex and gender differences in the management of AD patients. Further research should investigate how to implement gender targeted therapies and prevention, and their effects.