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The Diversity of Concentrated Prescribing Behavior: An Application to Antipsychotics

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  • Anna A. Levine Taub
  • Anton Kolotilin
  • Robert S. Gibbons
  • Ernst R. Berndt

Abstract

Physicians prescribing drugs for patients with schizophrenia and related conditions are remarkably concentrated in their choice among antipsychotic drugs. In 2007 the single antipsychotic drug prescribed by a physician accounted for 66% of all antipsychotic prescriptions written by that physician. Which particular branded antipsychotic was the prescriber's "favorite" varied widely across physicians, i.e. physician prescribing concentration patterns are diverse. Building on Frank and Zeckhauser's [2007] characterization of physician treatments varying from "custom made" to "ready-to-wear", we construct a model of physician learning that generates a number of hypotheses. Using 2007 annual antipsychotic prescribing behavior on 17,652 physicians from IMS Health, we evaluate these predictions empirically. While physician prescribing behavior is generally quite concentrated, prescribers having greater volumes, those with training in psychiatry, male prescribers, and those not approaching retirement age tend to have less concentrated prescribing patterns.

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Bibliographic Info

Paper provided by National Bureau of Economic Research, Inc in its series NBER Working Papers with number 16823.

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Date of creation: Feb 2011
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Handle: RePEc:nbr:nberwo:16823

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  1. Jovanovic, Boyan & Nyarko, Yaw, 1996. "Learning by Doing and the Choice of Technology," Econometrica, Econometric Society, vol. 64(6), pages 1299-1310, November.
  2. Duggan, Mark, 2005. "Do new prescription drugs pay for themselves?: The case of second-generation antipsychotics," Journal of Health Economics, Elsevier, vol. 24(1), pages 1-31, January.
  3. Tomas J. Philipson & Seth A. Seabury & Lee M. Lockwood & Dana P. Goldman & Darius N. Lakdawalla, 2010. "Geographic Variation in Health Care: The Role of Private Markets," Brookings Papers on Economic Activity, Economic Studies Program, The Brookings Institution, vol. 41(1 (Spring), pages 325-361.
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  7. Frank, Richard G. & Zeckhauser, Richard J., 2007. "Custom-made versus ready-to-wear treatments: Behavioral propensities in physicians' choices," Journal of Health Economics, Elsevier, vol. 26(6), pages 1101-1127, December.
  8. Marianne Bertrand & Antoinette Schoar, 2003. "Managing With Style: The Effect Of Managers On Firm Policies," The Quarterly Journal of Economics, MIT Press, vol. 118(4), pages 1169-1208, November.
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Cited by:
  1. David Cutler & Jonathan Skinner & Ariel Dora Stern & David Wennberg, 2013. "Physician Beliefs and Patient Preferences: A New Look at Regional Variation in Health Care Spending," NBER Working Papers 19320, National Bureau of Economic Research, Inc.
  2. Mariana Carrera & Dana Goldman & Geoffrey Joyce, 2013. "Heterogeneity in Cost-Sharing and Cost-Sensitivity, and the Role of the Prescribing Physician," NBER Working Papers 19186, National Bureau of Economic Research, Inc.

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