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A Prescription for Knowledge: Patient Information and Generic Substitution

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  • Hjalmarsson, Linn
  • Schmid, Christian P.R.
  • Schreiner, Nicolas

Abstract

Markets require informed participants to function efficiently. This paper examines the impact of providing targeted information directly to patients on their purchasing-decisions regarding pharmaceutical drugs. We analyze the effect of informational letters sent by a Swiss health insurer to clients who had recently purchased a brand-name drug, informing them of available generic alternatives and potential savings. Utilizing the quasi-randomized timing of the letter dispatch, we employ an event study design with staggered treatment adoption to estimate the causal effect of patient information on generic substitution probability. Based on 540,000 drug purchases by 60,000 patients we find that the probability of switching to a generic alternative increases by almost 30 percentage points immediately after receiving the informational letter, representing nearly a fourfold rise in the substitution likelihood among previous brand-name drug buyers. Furthermore, the effect does not substantially depend on whether patients face a copayment for their drug purchase and thus personally financially benefit from switching. Our results highlight the limits of healthcare policies that rely solely on financial incentives, particularly if patients lack sufficient information in their decision-making.

Suggested Citation

  • Hjalmarsson, Linn & Schmid, Christian P.R. & Schreiner, Nicolas, 2024. "A Prescription for Knowledge: Patient Information and Generic Substitution," Working papers 2024/05, Faculty of Business and Economics - University of Basel.
  • Handle: RePEc:bsl:wpaper:2024/05
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    References listed on IDEAS

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    1. Janssen, Aljoscha & Granlund, David, 2023. "The importance of the first generic substitution: Evidence from Sweden," Journal of Economic Behavior & Organization, Elsevier, vol. 213(C), pages 1-25.
    2. Mariana Carrera & Sofia Villas-Boas, 2023. "Generic Aversion and Observational Learning in the Over-the-Counter Drug Market," American Economic Journal: Applied Economics, American Economic Association, vol. 15(3), pages 380-410, July.
    3. 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.
    4. Yan Song & Douglas Barthold, 2018. "The effects of state‐level pharmacist regulations on generic substitution of prescription drugs," Health Economics, John Wiley & Sons, Ltd., vol. 27(11), pages 1717-1737, November.
    5. Jeffrey Clemens & Joshua D. Gottlieb, 2014. "Do Physicians' Financial Incentives Affect Medical Treatment and Patient Health?," American Economic Review, American Economic Association, vol. 104(4), pages 1320-1349, April.
    6. Leemore Dafny & Christopher Ody & Matt Schmitt, 2017. "When Discounts Raise Costs: The Effect of Copay Coupons on Generic Utilization," American Economic Journal: Economic Policy, American Economic Association, vol. 9(2), pages 91-123, May.
    7. Ito, Yuki & Hara, Konan & Kobayashi, Yasuki, 2020. "The effect of inertia on brand-name versus generic drug choices," Journal of Economic Behavior & Organization, Elsevier, vol. 172(C), pages 364-379.
    8. Drake, Coleman & Ryan, Conor & Dowd, Bryan, 2022. "Sources of inertia in the individual health insurance market," Journal of Public Economics, Elsevier, vol. 208(C).
    9. Müller, Tobias & Schmid, Christian & Gerfin, Michael, 2023. "Rents for Pills: Financial incentives and physician behavior," Journal of Health Economics, Elsevier, vol. 87(C).
    10. Katherine Baicker & Sendhil Mullainathan & Joshua Schwartzstein, 2015. "Behavioral Hazard in Health Insurance," The Quarterly Journal of Economics, President and Fellows of Harvard College, vol. 130(4), pages 1623-1667.
    11. Callaway, Brantly & Sant’Anna, Pedro H.C., 2021. "Difference-in-Differences with multiple time periods," Journal of Econometrics, Elsevier, vol. 225(2), pages 200-230.
    12. Michael Sinkinson & Amanda Starc, 2019. "Ask Your Doctor? Direct-to-Consumer Advertising of Pharmaceuticals," The Review of Economic Studies, Review of Economic Studies Ltd, vol. 86(2), pages 836-881.
    13. Goodman-Bacon, Andrew, 2021. "Difference-in-differences with variation in treatment timing," Journal of Econometrics, Elsevier, vol. 225(2), pages 254-277.
    14. Granlund, David & Sundström, David, 2018. "Physicians prescribing originals causes welfare losses," Economics Letters, Elsevier, vol. 170(C), pages 143-146.
    15. Liu, Ya-Ming & Yang, Yea-Huei Kao & Hsieh, Chee-Ruey, 2009. "Financial incentives and physicians' prescription decisions on the choice between brand-name and generic drugs: Evidence from Taiwan," Journal of Health Economics, Elsevier, vol. 28(2), pages 341-349, March.
    16. Sun, Liyang & Abraham, Sarah, 2021. "Estimating dynamic treatment effects in event studies with heterogeneous treatment effects," Journal of Econometrics, Elsevier, vol. 225(2), pages 175-199.
    17. Florian Heiss & Daniel McFadden & Joachim Winter & Amelie Wuppermann & Bo Zhou, 2021. "Inattention and Switching Costs as Sources of Inertia in Medicare Part D," American Economic Review, American Economic Association, vol. 111(9), pages 2737-2781, September.
    18. 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.
    19. Bradley T. Shapiro, 2022. "Promoting Wellness or Waste? Evidence from Antidepressant Advertising," American Economic Journal: Microeconomics, American Economic Association, vol. 14(2), pages 439-477, May.
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    Keywords

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    JEL classification:

    • D12 - Microeconomics - - Household Behavior - - - Consumer Economics: Empirical Analysis
    • D83 - Microeconomics - - Information, Knowledge, and Uncertainty - - - Search; Learning; Information and Knowledge; Communication; Belief; Unawareness
    • D90 - Microeconomics - - Micro-Based Behavioral Economics - - - General
    • I11 - Health, Education, and Welfare - - Health - - - Analysis of Health Care Markets
    • I12 - Health, Education, and Welfare - - Health - - - Health Behavior
    • I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health

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