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Entry and price competition in the over‐the‐counter drug market after deregulation: Evidence from Portugal


  • Ana Moura
  • Pedro Pita Barros


In the last two decades, many European countries allowed the sale of over‐the‐counter (OTC) drugs outside pharmacies. This was expected to lower retail prices through increased competition. Evidence of such price reductions is scarce. We assess the impact of supermarket and outlet entry in the OTC drug market on OTC prices charged by incumbent pharmacies using a difference‐in‐differences strategy. We use price data on five popular OTC drugs for all retailers located in Lisbon for three distinct points in time (2006, 2010, and 2015). Our results suggest that competitive pressure in the market is mainly exerted by supermarkets, which charge, on average, 20% lower prices than pharmacies. The entry of a supermarket among the main competitors of an incumbent pharmacy is associated with an average 4% to 6% decrease in prices relative to the control group. These price reductions are long‐lasting but fairly localized. We find no evidence of price reductions following OTC outlet entry. Additional results from a reduced‐form entry model and a propensity score matching difference‐in‐differences approach support the view that these effects are causal.

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  • 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.
  • Handle: RePEc:wly:hlthec:v:29:y:2020:i:8:p:865-877
    DOI: 10.1002/hec.4109

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    1. A. Smith, Jeffrey & E. Todd, Petra, 2005. "Does matching overcome LaLonde's critique of nonexperimental estimators?," Journal of Econometrics, Elsevier, vol. 125(1-2), pages 305-353.
    2. James J. Heckman & Hidehiko Ichimura & Petra E. Todd, 1997. "Matching As An Econometric Evaluation Estimator: Evidence from Evaluating a Job Training Programme," Review of Economic Studies, Oxford University Press, vol. 64(4), pages 605-654.
    3. 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.
    4. Morgall, Janine Marie & Almarsdóttir, Anna Birna, 1999. "No struggle, no strength: how pharmacists lost their monopoly," Social Science & Medicine, Elsevier, vol. 48(9), pages 1247-1258, May.
    5. Alberto Abadie & Susan Athey & Guido Imbens & Jeffrey Wooldridge, 2017. "When Should You Adjust Standard Errors for Clustering?," Papers 1710.02926,, revised Oct 2017.
    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. 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.
    8. Steven C. Salop, 1979. "Monopolistic Competition with Outside Goods," Bell Journal of Economics, The RAND Corporation, vol. 10(1), pages 141-156, Spring.
    9. Hosken, Daniel S. & McMillan, Robert S. & Taylor, Christopher T., 2008. "Retail gasoline pricing: What do we know?," International Journal of Industrial Organization, Elsevier, vol. 26(6), pages 1425-1436, November.
    10. Heij, Christiaan & de Boer, Paul & Franses, Philip Hans & Kloek, Teun & van Dijk, Herman K., 2004. "Econometric Methods with Applications in Business and Economics," OUP Catalogue, Oxford University Press, number 9780199268016.
    11. Waterson, Michael, 1993. "Retail Pharmacy in Melbourne: Actual and Optimal Densities," Journal of Industrial Economics, Wiley Blackwell, vol. 41(4), pages 403-419, December.
    12. 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.
    13. 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.
    14. 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.
    15. Daniel Bennett & Wesley Yin, 2014. "The Market for High-Quality Medicine," NBER Working Papers 20091, National Bureau of Economic Research, Inc.
    16. Céline Pilorge, 2016. "Monopole officinal et concurrence en prix pour la délivrance des médicaments non remboursables : l’exemple français," Revue économique, Presses de Sciences-Po, vol. 67(5), pages 1057-1084.
    17. Anell, Anders, 2005. "Deregulating the pharmacy market: the case of Iceland and Norway," Health Policy, Elsevier, vol. 75(1), pages 9-17, December.
    18. Alan T. Sorensen, 2000. "Equilibrium Price Dispersion in Retail Markets for Prescription Drugs," Journal of Political Economy, University of Chicago Press, vol. 108(4), pages 833-862, August.
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