Cost Containment and Managed Care: Evidence from German Macro Data
AbstractThe major German health care reforms undertaken since the late 1990s resulted in the adoption of selective contracting mechanisms in a formerly sectorally separated health care system. These reforms marked the launch of managed care in Germany that is expected to yield both a higher quality of care and cost containment. We investigate if managed care had an in fluence on the structure of health care expenditure in Germany during the start-up phase of managed care from 2004 to 2008. We focus on pharmaceutical spending by statutory sickness funds (i.e. German law- enforced health insurance). We followed a macroeconomic evaluation approach based on a regional panel data set in contrast to previous research and were thus able to control for a comprehensive set of regional and demographic variables. We discuss alternative model specifications and include a range of sensitivity analyses. Our results suggest that in contrast to public perception the share of managed care contracts has a positive impact on pharmaceutical spending.
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Bibliographic InfoPaper provided by University of Lüneburg, Institute of Economics in its series Working Paper Series in Economics with number 284.
Length: 28 pages
Date of creation: Oct 2013
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Managed care; Health care expenditure; Pharmaceutical expenditur; Panel data; German health care reform;
Find related papers by JEL classification:
- I11 - Health, Education, and Welfare - - Health - - - Analysis of Health Care Markets
- I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health
- L14 - Industrial Organization - - Market Structure, Firm Strategy, and Market Performance - - - Transactional Relationships; Contracts and Reputation
- O52 - Economic Development, Technological Change, and Growth - - Economywide Country Studies - - - Europe
This paper has been announced in the following NEP Reports:
- NEP-ALL-2013-10-25 (All new papers)
- NEP-EUR-2013-10-25 (Microeconomic European Issues)
- NEP-HEA-2013-10-25 (Health Economics)
- NEP-IAS-2013-10-25 (Insurance Economics)
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- Luca Crivelli & Massimo Filippini & Ilaria Mosca, 2006. "Federalism and regional health care expenditures: an empirical analysis for the Swiss cantons," Health Economics, John Wiley & Sons, Ltd., vol. 15(5), pages 535-541.
- Hitiris, Theo & Posnett, John, 1992. "The determinants and effects of health expenditure in developed countries," Journal of Health Economics, Elsevier, Elsevier, vol. 11(2), pages 173-181, August.
- Michael D. Murray & Frank W. Deardorff, 1998. "Does Managed Care Fuel Pharmaceutical Industry Growth?," PharmacoEconomics, Springer Healthcare | Adis, Springer Healthcare | Adis, vol. 14(4), pages 341-348.
- Oliver Reich & Cornelia Weins & Claudia Schusterschitz & Magdalena Thöni, 2012. "Exploring the disparities of regional health care expenditures in Switzerland: some empirical evidence," The European Journal of Health Economics, Springer, Springer, vol. 13(2), pages 193-202, April.
- Parkin, David & McGuire, Alistair & Yule, Brian, 1987. "Aggregate health care expenditures and national income : Is health care a luxury good?," Journal of Health Economics, Elsevier, Elsevier, vol. 6(2), pages 109-127, June.
- Joan Costa Font & Jordi Pons Novell, 2005.
"Public Health Expenditure and Spatial Interactions in a Decentralized National Health System,"
Working Papers in Economics
139, Universitat de Barcelona. Espai de Recerca en Economia.
- Joan Costa-Font & Jordi Pons-Novell, 2007. "Public health expenditure and spatial interactions in a decentralized national health system," Health Economics, John Wiley & Sons, Ltd., vol. 16(3), pages 291-306.
- Alan Lyles & Francis B. Palumbo, 1999. "The Effect of Managed Care on Prescription Drug Costs and Benefits," PharmacoEconomics, Springer Healthcare | Adis, Springer Healthcare | Adis, vol. 15(2), pages 129-140.
- Guillem López-Casasnovas & Marc Saez, 2007. "A multilevel analysis on the determinants of regional health care expenditure: a note," The European Journal of Health Economics, Springer, Springer, vol. 8(1), pages 59-65, March.
- Schmitz, Hendrik, 2011. "Why are the unemployed in worse health? The causal effect of unemployment on health," Labour Economics, Elsevier, Elsevier, vol. 18(1), pages 71-78, January.
- Okunade, Albert A. & Suraratdecha, Chutima, 2006. "The pervasiveness of pharmaceutical expenditure inertia in the OECD countries," Social Science & Medicine, Elsevier, Elsevier, vol. 63(1), pages 225-238, July.
- David Prieto & Santiago Lago-Peñas, 2012. "Decomposing the determinants of health care expenditure: the case of Spain," The European Journal of Health Economics, Springer, Springer, vol. 13(1), pages 19-27, February.
- Marisa Elena Domino & David S. Salkever, 2003. "Price elasticity and pharmaceutical selection: the influence of managed care," Health Economics, John Wiley & Sons, Ltd., vol. 12(7), pages 565-586.
- Yves Croissant & Giovanni Millo, . "Panel Data Econometrics in R: The plm Package," Journal of Statistical Software, American Statistical Association, American Statistical Association, vol. 27(i02).
- Gerdtham, Ulf-G. & Sogaard, Jes & Andersson, Fredrik & Jonsson, Bengt, 1992. "An econometric analysis of health care expenditure: A cross-section study of the OECD countries," Journal of Health Economics, Elsevier, Elsevier, vol. 11(1), pages 63-84, May.
- Baltagi, Badi H. & Li, Qi, 1991. "A joint test for serial correlation and random individual effects," Statistics & Probability Letters, Elsevier, Elsevier, vol. 11(3), pages 277-280, March.
- Atella, Vincenzo, 2000. "Drug cost containment policies in Italy: are they really effective in the long-run?: The case of minimum reference price," Health Policy, Elsevier, Elsevier, vol. 50(3), pages 197-218, January.
- Baltagi, Badi H. & Li, Qi, 1995. "Testing AR(1) against MA(1) disturbances in an error component model," Journal of Econometrics, Elsevier, Elsevier, vol. 68(1), pages 133-151, July.
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