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Ask Your Doctor or Pharmacist! On the Effect of Self-Dispensing Physicians on Pharmaceutical Coverage

In most developed countries drugs are dispensed to patients through physicians and pharmacists. This paper studies the eects of allowing doctors to directly dispense drugs to patients (self-dispensation) on pharmaceutical coverage. We use a Swiss dataset in our empirical analysis because Switzerland's federalist legislation allows us to study self-dispensing and non-self-dispensing regimes alike. We add location information obtained from Google Geocoding services to our dataset in order to measure coverage based on distances. To capture a driver of long term positioning decisions, we take revenues as a proxy for a pharmacy's usage rate. We nd that, ceteris paribus, self-dispensation leads to a lowered regional density of pharmacies. By matching similar pharmacies across both regimes we nd that revenues are substantially lower for pharmacies under a self-dispensation regime. Pharmacies in cantons that allow physicians to dispense drugs tend to have relatively higher revenues associated with non-drugs. We suggest to organize legislation on self-dispensation at a ne grained regional level as regional typologies are the most reasonable justication for regime choice.

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File URL: http://dx.doi.org/10.3929/ethz-a-010479991
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Paper provided by KOF Swiss Economic Institute, ETH Zurich in its series KOF Working papers with number 15-387.

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Length: 33 pages
Date of creation: Jun 2015
Handle: RePEc:kof:wpskof:15-387
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  1. Boris Kaiser & Christian Schmid, 2013. "Does Physician Dispensing Increase Drug Expenditures?," Diskussionsschriften dp1303, Universitaet Bern, Departement Volkswirtschaft.
  2. Maurus Rischatsch & Maria Trottmann, 2009. "Physician dispensing and the choice between generic and brand-name drugs – Do margins affect choice?," SOI - Working Papers 0911, Socioeconomic Institute - University of Zurich.
  3. Lim, David & Emery, Jon & Lewis, Janice & Sunderland, V Bruce, 2009. "A systematic review of the literature comparing the practices of dispensing and non-dispensing doctors," Health Policy, Elsevier, vol. 92(1), pages 1-9, September.
  4. Rosenbaum, Paul R., 2010. "Design Sensitivity and Efficiency in Observational Studies," Journal of the American Statistical Association, American Statistical Association, vol. 105(490), pages 692-702.
  5. Sekhon, Jasjeet S., 2011. "Multivariate and Propensity Score Matching Software with Automated Balance Optimization: The Matching package for R," Journal of Statistical Software, Foundation for Open Access Statistics, vol. 42(i07).
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