IDEAS home Printed from https://ideas.repec.org/p/bdi/wptemi/td_1388_22.html
   My bibliography  Save this paper

Liberalizing the opening of new pharmacies and hospitalizations

Author

Listed:
  • Andrea Cintolesi

    (Bank of Italy)

  • Andrea Riganti

    (University of Milan)

Abstract

We study the impact of legal restrictions pertaining to pharmacy licences on hospitalizations. We use a reform approved in 2012 in Italy that increased the number of pharmacies allowed to operate in the national territory by 8%. We set up a regression discontinuity design exploiting monthly data on hospitalizations within Italian provinces. We find that an 8% increase in the number of pharmacies decreased medical hospitalizations by 1.1% and related expenditures by 1.3%. This drop is mainly driven by short hospitalizations of children and elderly individuals. On average, every new pharmacy prevents 17 medical hospitalizations every year. We do not find an impact on a control group of surgical hospitalizations, and we validate the results with a battery of placebo tests. Pharmacies appear to reduce hospitalizations by giving information to people who would otherwise be admitted to a hospital, and other mechanisms are not supported by the data.

Suggested Citation

  • Andrea Cintolesi & Andrea Riganti, 2022. "Liberalizing the opening of new pharmacies and hospitalizations," Temi di discussione (Economic working papers) 1388, Bank of Italy, Economic Research and International Relations Area.
  • Handle: RePEc:bdi:wptemi:td_1388_22
    as

    Download full text from publisher

    File URL: https://www.bancaditalia.it/pubblicazioni/temi-discussione/2022/2022-1388/en_tema_1388.pdf
    Download Restriction: no
    ---><---

    References listed on IDEAS

    as
    1. Flavio Delbono & Vincenzo Denicolo, 1991. "Incentives to Innovate in a Cournot Oligopoly," The Quarterly Journal of Economics, President and Fellows of Harvard College, vol. 106(3), pages 951-961.
    2. Mocetti, Sauro, 2016. "Dynasties in professions and the role of rents and regulation: Evidence from Italian pharmacies," Journal of Public Economics, Elsevier, vol. 133(C), pages 1-10.
    3. Lippi Bruni, Matteo & Mammi, Irene & Ugolini, Cristina, 2016. "Does the extension of primary care practice opening hours reduce the use of emergency services?," Journal of Health Economics, Elsevier, vol. 50(C), pages 144-155.
    4. Sebastian Calonico & Matias D. Cattaneo & Rocio Titiunik, 2014. "Robust Nonparametric Confidence Intervals for Regression‐Discontinuity Designs," Econometrica, Econometric Society, vol. 82, pages 2295-2326, November.
    5. Catherine Hausman & David S. Rapson, 2018. "Regression Discontinuity in Time: Considerations for Empirical Applications," Annual Review of Resource Economics, Annual Reviews, vol. 10(1), pages 533-552, October.
    6. Martins, Lurdes & Queirós, Sónia, 2015. "Competition among pharmacies and the typology of services delivered: The Portuguese case," Health Policy, Elsevier, vol. 119(5), pages 640-647.
    7. Stargardt, Tom & Schreyögg, Jonas & Busse, Reinhard, 2007. "Pricing behaviour of pharmacies after market deregulation for OTC drugs: The case of Germany," Health Policy, Elsevier, vol. 84(1), pages 30-38, November.
    8. Lluch, Maria & Kanavos, Panos, 2010. "Impact of regulation of Community Pharmacies on efficiency, access and equity. Evidence from the UK and Spain," Health Policy, Elsevier, vol. 95(2-3), pages 245-254, May.
    9. Catherine Schaumans & Frank Verboven, 2008. "Entry and regulation: evidence from health care professions," RAND Journal of Economics, RAND Corporation, vol. 39(4), pages 949-972, December.
    10. Alexander, Diane & Currie, Janet & Schnell, Molly, 2019. "Check up before you check out: Retail clinics and emergency room use," Journal of Public Economics, Elsevier, vol. 178(C).
    11. Rudholm, Niklas, 2008. "Entry of new pharmacies in the deregulated Norwegian pharmaceuticals market--Consequences for costs and availability," Health Policy, Elsevier, vol. 87(2), pages 258-263, August.
    12. Steven C. Salop, 1979. "Monopolistic Competition with Outside Goods," Bell Journal of Economics, The RAND Corporation, vol. 10(1), pages 141-156, Spring.
    13. Chen, Xu & Li, Shanshan & Wang, Xiaojun, 2020. "Evaluating the effects of quality regulations on the pharmaceutical supply chain," International Journal of Production Economics, Elsevier, vol. 230(C).
    14. Giacomo Calzolari & Andrea Ichino & Francesco Manaresi & Viki Nellas, 2018. "Inelastic Buyers and Competition," Economic Journal, Royal Economic Society, vol. 128(615), pages 2843-2875, November.
    15. Bhagwati, Jagdish N, 1970. "Oligopoly Theory, Entry-prevention, and Growth," Oxford Economic Papers, Oxford University Press, vol. 22(3), pages 297-310, November.
    16. Anell, Anders, 2005. "Deregulating the pharmacy market: the case of Iceland and Norway," Health Policy, Elsevier, vol. 75(1), pages 9-17, December.
    17. Ana Moura & Pedro Pita Barros, 2020. "Entry and price competition in the over‐the‐counter drug market after deregulation: Evidence from Portugal," Health Economics, John Wiley & Sons, Ltd., vol. 29(8), pages 865-877, August.
    18. J. N. Bhagwati, 1970. "Oligopoly Theory, Entry-Prevention and Growth," Working papers 47, Massachusetts Institute of Technology (MIT), Department of Economics.
    Full references (including those not matched with items on IDEAS)

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Ana Moura & Pedro Pita Barros, 2020. "Entry and price competition in the over‐the‐counter drug market after deregulation: Evidence from Portugal," Health Economics, John Wiley & Sons, Ltd., vol. 29(8), pages 865-877, August.
    2. Moura, Ana, 2021. "Essays in health economics," Other publications TiSEM c93abd22-fa4a-42a5-b172-d, Tilburg University, School of Economics and Management.
    3. Jo, Wooyong & Nam, Hyoryung & Choi, Jeonghye, 2022. "Opening the OTC drug market: The effect of deregulation on retail pharmacy’s performance," International Journal of Research in Marketing, Elsevier, vol. 39(3), pages 847-866.
    4. Vogler, Sabine & Habimana, Katharina & Arts, Danielle, 2014. "Does deregulation in community pharmacy impact accessibility of medicines, quality of pharmacy services and costs? Evidence from nine European countries," Health Policy, Elsevier, vol. 117(3), pages 311-327.
    5. Barbarisi, Ilaria & Bruno, Giuseppe & Diglio, Antonio & Elizalde, Javier & Piccolo, Carmela, 2019. "A spatial analysis to evaluate the impact of deregulation policies in the pharmacy sector: Evidence from the case of Navarre," Health Policy, Elsevier, vol. 123(11), pages 1108-1115.
    6. David, Guy & Smith-McLallen, Aaron & Ukert, Benjamin, 2019. "The effect of predictive analytics-driven interventions on healthcare utilization," Journal of Health Economics, Elsevier, vol. 64(C), pages 68-79.
    7. Gallone, Emma Luisa & Ravetto Enri, Lorenzo & Pignata, Irene & Baratta, Francesca & Brusa, Paola, 2020. "The 2017 deregulation of pharmacies in Italy: Introducing non-pharmacist ownership," Health Policy, Elsevier, vol. 124(12), pages 1281-1286.
    8. Bart Cockx & Sam Desiere, 2023. "Labour costs and the decision to hire the first employee," Working Papers of Faculty of Economics and Business Administration, Ghent University, Belgium 23/1071, Ghent University, Faculty of Economics and Business Administration.
    9. Hansen, Benjamin & Miller, Keaton & Weber, Caroline, 2020. "Federalism, partial prohibition, and cross-border sales: Evidence from recreational marijuana," Journal of Public Economics, Elsevier, vol. 187(C).
    10. Connor, John M & Peterson, Everett B, 1992. "Market-Structure Determinants of National Brand-Private Label Price Differences of Manufactured Food Products," Journal of Industrial Economics, Wiley Blackwell, vol. 40(2), pages 157-171, June.
    11. Mauricio Villamizar‐Villegas & Freddy A. Pinzon‐Puerto & Maria Alejandra Ruiz‐Sanchez, 2022. "A comprehensive history of regression discontinuity designs: An empirical survey of the last 60 years," Journal of Economic Surveys, Wiley Blackwell, vol. 36(4), pages 1130-1178, September.
    12. Tu, Meng & Zhang, Bing & Xu, Jianhua & Lu, Fangwen, 2020. "Mass media, information and demand for environmental quality: Evidence from the “Under the Dome”," Journal of Development Economics, Elsevier, vol. 143(C).
    13. Jael, Paul, 2015. "Price, target rate of profit and entry preventing," MPRA Paper 65970, University Library of Munich, Germany.
    14. Brachert, Matthias, 2018. "The regional effects of professional sports franchises: Causal evidence from four European football leagues," IWH Discussion Papers 10/2018, Halle Institute for Economic Research (IWH).
    15. Jael, Paul, 2014. "Full cost, profit et concurrence [Full cost, Profit and Competition]," MPRA Paper 64406, University Library of Munich, Germany.
    16. Fraser Summerfield, 2016. "Matching Skill and Tasks: Cyclical Fluctuations in the Overqualification of New Hires," Working Paper series 16-08, Rimini Centre for Economic Analysis.
    17. Calá, Carla Daniela, 2009. "Spatial issues on firm demography: an analysis for Argentina," Nülan. Deposited Documents 1379, Universidad Nacional de Mar del Plata, Facultad de Ciencias Económicas y Sociales, Centro de Documentación.
    18. Aguilar, Arturo & Gutierrez, Emilio & Seira, Enrique, 2021. "The effectiveness of sin food taxes: Evidence from Mexico," Journal of Health Economics, Elsevier, vol. 77(C).
    19. Calá, Carla Daniela, 2014. "Regional issues on firm entry and exit in Argentina: core and peripheral regions," Nülan. Deposited Documents 2023, Universidad Nacional de Mar del Plata, Facultad de Ciencias Económicas y Sociales, Centro de Documentación.
    20. Kheiravar, Khaled H, 2019. "Economic and Econometric Analyses of the World Petroleum Industry, Energy Subsidies, and Air Pollution," Institute of Transportation Studies, Working Paper Series qt3gj151w9, Institute of Transportation Studies, UC Davis.

    More about this item

    Keywords

    regulation; pharmacies; license; healthcare expenditures; hospitalizations;
    All these keywords.

    JEL classification:

    • D45 - Microeconomics - - Market Structure, Pricing, and Design - - - Rationing; Licensing
    • H51 - Public Economics - - National Government Expenditures and Related Policies - - - Government Expenditures and Health
    • I10 - Health, Education, and Welfare - - Health - - - General
    • K20 - Law and Economics - - Regulation and Business Law - - - General

    NEP fields

    This paper has been announced in the following NEP Reports:

    Statistics

    Access and download statistics

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:bdi:wptemi:td_1388_22. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: the person in charge (email available below). General contact details of provider: https://edirc.repec.org/data/bdigvit.html .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.