Methods for evaluating patient utility: an economic and econometric analysis of adherence behavior in a clinical trial.

Summary This work develops an economic evaluation analysis in the health field in order to compare two therapeutic strategies. The method consists in observing behaviors in individual decision situations. We postulate that patient compliance behavior could be used as a tool to reveal preferences. The microeconomic model formalizes the hypothesis that adherence results from the patient's rational trade-off between the benefits and costs associated with treatment. The econometric specification evaluates the welfare gain from therapy and analyzes the determinants of good adherence while controlling for the fact that it influences health status. We estimate a simultaneous non-linear system on panel data from observations of an HIV clinical trial. The theoretical model and the empirical results suggest that a lower level of adherence implies that the cost-benefit ratio of the therapy is higher.