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Antibiotic Demand in the Presence of Antimicrobial Resistance

Author

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  • Pierre Dubois

    (TSE-R - Toulouse School of Economics - UT Capitole - Université Toulouse Capitole - Comue de Toulouse - Communauté d'universités et établissements de Toulouse - EHESS - École des hautes études en sciences sociales - CNRS - Centre National de la Recherche Scientifique - INRAE - Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement)

  • Gokce Gokkoca

    (TSE-R - Toulouse School of Economics - UT Capitole - Université Toulouse Capitole - Comue de Toulouse - Communauté d'universités et établissements de Toulouse - EHESS - École des hautes études en sciences sociales - CNRS - Centre National de la Recherche Scientifique - INRAE - Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement)

Abstract

Antimicrobial resistance (AMR) increases hospital stays, medical costs and mortality. Antibiotic consumption and resulting selective pressure on bacteria can create AMR. We study the role of AMR on changes in prescriptions of antibiotics in France for treating bladder inflammation (cystitis) using a representative sample of general practitioners between 2002 and 2019. Effects of resistance on demand and substitution behavior are identified via a random coefficient logit model, controlling for the endogeneity of resistance using antibiotics sales in veterinary medicine. As resistance increases, physicians substitute to other drugs, and we test whether physicians consider predictable resistance evolution in their decisions. We perform counterfactual analysis assessing the impact of decreasing veterinary use of antibiotics and limiting fluoroquinolone use to treat cystitis. Both policies reduce resistance against fluoroquinolones but have opposite effects on substitution behavior and consumer surplus. Finally, we propose a method for the optimal pricing of rapid bacterial detection and antibiotic susceptibility testing.

Suggested Citation

  • Pierre Dubois & Gokce Gokkoca, 2025. "Antibiotic Demand in the Presence of Antimicrobial Resistance," Working Papers hal-04964078, HAL.
    • Handle: RePEc:hal:wpaper:hal-04964078
    Note: View the original document on HAL open archive server: https://hal.science/hal-04964078v1
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    Cited by:

    1. is not listed on IDEAS
    2. Gökkoca, Gökçe, 2024. "Antibiotic Stewardship in Primary Care: Evidence from Pay-for-Performance in France," TSE Working Papers 24-1567, Toulouse School of Economics (TSE).
    3. Hannes Ullrich & Michael Allan Ribers, 2023. "Machine predictions and human decisions with variation in payoffs and skill: the case of antibiotic prescribing," Berlin School of Economics Discussion Papers 0027, Berlin School of Economics.

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    Keywords

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    JEL classification:

    • I10 - Health, Education, and Welfare - - Health - - - General
    • D12 - Microeconomics - - Household Behavior - - - Consumer Economics: Empirical Analysis
    • L11 - Industrial Organization - - Market Structure, Firm Strategy, and Market Performance - - - Production, Pricing, and Market Structure; Size Distribution of Firms
    • C25 - Mathematical and Quantitative Methods - - Single Equation Models; Single Variables - - - Discrete Regression and Qualitative Choice Models; Discrete Regressors; Proportions; Probabilities

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