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Does Physician Dispensing Increase Drug Expenditures? Empirical Evidence from Switzerland

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  • Boris Kaiser
  • Christian Schmid

Abstract

This paper analyzes whether the opportunity for physicians to dispense drugs increases healthcare expenditures. We study the case of Switzerland, where dispensing physicians face financial incentives to overprescribe and sell more expensive pharmaceuticals. Using comprehensive physician‐level data, we exploit the regional variation in the dispensing regime to estimate causal effects. The empirical strategy consists of a doubly‐robust estimation that combines inverse probability weighting with regression. Our main finding suggests that dispensing leads to higher drug costs on the order of 34% per patient. Copyright © 2014 John Wiley & Sons, Ltd.

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  • Boris Kaiser & Christian Schmid, 2016. "Does Physician Dispensing Increase Drug Expenditures? Empirical Evidence from Switzerland," Health Economics, John Wiley & Sons, Ltd., vol. 25(1), pages 71-90, January.
  • Handle: RePEc:wly:hlthec:v:25:y:2016:i:1:p:71-90
    DOI: 10.1002/hec.3124
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    Cited by:

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    2. Rachamin, Yael & Meier, Rahel & Valeri, Fabio & Rosemann, Thomas & Muheim, Leander, 2021. "Physician-dispensing as a determinant of clinical and process measurements in patients at increased cardiovascular risk: A cross-sectional study in Swiss general practice," Health Policy, Elsevier, vol. 125(10), pages 1305-1310.
    3. Kanavos, Panos & Leon, Giovanny & Carbonel, Christophe & Rampuria, Aparajit & Singh Rajpoot, Ravindra & Joshi, Parth, 2024. "An assessment of the implications of distribution remuneration and taxation policies on the final prices of prescription medicines: evidence from 35 countries," LSE Research Online Documents on Economics 124243, London School of Economics and Political Science, LSE Library.
    4. Daniel Burkhard & Christian P. R. Schmid & Kaspar Wüthrich, 2019. "Financial incentives and physician prescription behavior: Evidence from dispensing regulations," Health Economics, John Wiley & Sons, Ltd., vol. 28(9), pages 1114-1129, September.
    5. Müller, Tobias & Schmid, Christian & Gerfin, Michael, 2023. "Rents for Pills: Financial incentives and physician behavior," Journal of Health Economics, Elsevier, vol. 87(C).
    6. Alexander Ahammer & Ivan Zilic, 2017. "Do Financial Incentives Alter Physician Prescription Behavior? Evidence from Random Patient-GP Allocations," Working Papers 1701, The Institute of Economics, Zagreb.
    7. Luke Connelly & Gianluca Fiorentini & Marica Iommi, 2022. "Supply-side solutions targeting demand-side characteristics: causal effects of a chronic disease management program on adherence and health outcomes," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 23(7), pages 1203-1220, September.
    8. Boris Kaiser, 2017. "Gender-specific practice styles and ambulatory health care expenditures," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 18(9), pages 1157-1179, December.
    9. Zhou, Cuihua & Hao, Yifei & Lan, Yanfei & Li, Weifeng, 2023. "To introduce or not? Strategic analysis of hospital operations with telemedicine," European Journal of Operational Research, Elsevier, vol. 304(1), pages 292-307.
    10. Chi Shen & Qiwei Deng & Sha Lai & Liu Yang & Dantong Zhao & Yaxin Zhao & Zhongliang Zhou, 2024. "New evidence on supplier-induced demand in China’s public tertiary hospitals: is the cost of hospitalization higher in the off-season?," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 25(6), pages 951-962, August.
    11. Fabienne Loetscher, Christian P.R. Schmid, Michael Gerfin, "undated". "The effect of higher out-of-pocket payments on drug prices and demand," Diskussionsschriften dp2405, Universitaet Bern, Departement Volkswirtschaft.
    12. Olivia Bodnar & Hugh Gravelle & Nils Gutacker & Annika Herr, 2024. "Financial incentives and prescribing behavior in primary care," Health Economics, John Wiley & Sons, Ltd., vol. 33(4), pages 696-713, April.
    13. Lagarde, Mylène & Blaauw, Duane, 2022. "Overtreatment and benevolent provider moral hazard: Evidence from South African doctors," Journal of Development Economics, Elsevier, vol. 158(C).
    14. Lagarde, Mylène & Blaauw, Duane, 2022. "Overtreatment and benevolent provider moral hazard: evidence from South African doctors," LSE Research Online Documents on Economics 115383, London School of Economics and Political Science, LSE Library.
    15. Stacherl, Barbara & Renner, Anna-Theresa & Weber, Daniela, 2023. "Financial incentives and antibiotic prescribing patterns: Evidence from dispensing physicians in a public healthcare system," Social Science & Medicine, Elsevier, vol. 321(C).
    16. Henry, Edward & Cullinan, John, 2021. "Mental health spillovers from serious family illness: Doubly robust estimation using EQ-5D-5L population normative data," Social Science & Medicine, Elsevier, vol. 279(C).

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