IDEAS home Printed from https://ideas.repec.org/
MyIDEAS: Login to save this paper or follow this series

Antibiotic consumption and the role of dispensing physicians

  • Massimo Filippini

    (Institute of Economics, University of Lugano; ETH, Zurich, Switzerland)

  • Fabian Heimsch

    (ETH, Zurich, Switzerland)

  • Giuliano Masiero

    ()

    (University of Bergamo, Italy; Institute of Economics, University of Lugano, Switzerland)

Regulation of prescription and dispensing of antibiotics has a twin purpose: to enhance access to antibiotic treatment and to reduce inappropriate use of drugs. Nevertheless, incentives on antibiotics to dispensing physicians may lead to inefficiencies. We model the interaction between competing physicians (with and without dispensing of drugs) and patients exposed to bacterial infections when antibiotic treatment generates spatial consumption externalities. Then, we empirically investigate the impact of dispensing practices on antibiotic consumption by means of combined spatial-lag and spatial-error econometric estimators for panel data (SARAR). The investigation exploits data from small geographic areas in a country where both regimes - with and without dispensing physicians - are possible. We find evidence that dispensing practices increase antibiotic use after controlling for determinants of demand and access, and spatial effects. This suggests that health authorities have a margin to adjust economic incentives on dispensing practices in order to reduce antibiotic misuse.

If you experience problems downloading a file, check if you have the proper application to view it first. In case of further problems read the IDEAS help page. Note that these files are not on the IDEAS site. Please be patient as the files may be large.

File URL: http://doc.rero.ch/record/31703/files/CEPRA_02_2013.pdf
Download Restriction: no

Paper provided by USI Università della Svizzera italiana in its series CEPRA working paper with number 1302.

as
in new window

Length: 34 pages
Date of creation: Mar 2013
Date of revision:
Handle: RePEc:lug:wcepra:1302
Contact details of provider: Web page: https://www.bul.sbu.usi.ch

References listed on IDEAS
Please report citation or reference errors to , or , if you are the registered author of the cited work, log in to your RePEc Author Service profile, click on "citations" and make appropriate adjustments.:

as in new window
  1. Jean-Pierre Lachaud, 2005. "HIV prevalence and poverty in Africa : micro and macro-econometric evidence applied to Burkina Faso," Documents de travail 113, Groupe d'Economie du Développement de l'Université Montesquieu Bordeaux IV.
  2. Izabela Jelovac, 2001. "Physicians' payment contracts, treatment decisions and diagnosis accuracy," Health Economics, John Wiley & Sons, Ltd., vol. 10(1), pages 9-25.
  3. Joan Costa-Font & Francesco Moscone, 2008. "The impact of decentralization and inter-territorial interactions on Spanish health expenditure," Empirical Economics, Springer, vol. 34(1), pages 167-184, February.
  4. Kurt R. Brekke & Tor Helge Holmås & Odd Rune Straume, 2010. "Reference Pricing, Competition, and Pharmaceutical Expenditures: Theory and Evidence from a Natural Experiment," CESifo Working Paper Series 3258, CESifo Group Munich.
  5. Moscone, Francesco & Knapp, Martin & Tosetti, Elisa, 2007. "Mental health expenditure in England: A spatial panel approach," Journal of Health Economics, Elsevier, vol. 26(4), pages 842-864, July.
  6. Rudholm, Niklas, 2002. "Economic implications of antibiotic resistance in a global economy," Journal of Health Economics, Elsevier, vol. 21(6), pages 1071-1083, November.
  7. Gravelle, Hugh, 1999. "Capitation contracts: access and quality," Journal of Health Economics, Elsevier, vol. 18(3), pages 315-340, June.
  8. Massimo Filippini & Giuliano Masiero, 2011. "An empirical analysis of habit and addiction to antibiotics," Working Papers 1110, Department of Economics and Technology Management, University of Bergamo.
  9. Brekke, Kurt R. & Nuscheler, Robert, 2003. "Gatekeeping in health care," Working Papers in Economics 10/03, University of Bergen, Department of Economics.
  10. J. Tirole & E. Maskin, 1982. "A Theory of Dynamic Oligopoly, I: Overview and Quantity Competition with Large-Fixed Costs," Working papers 320, Massachusetts Institute of Technology (MIT), Department of Economics.
  11. Brekke, Kurt Richard & Siciliani, Luigi & Straume, Odd Rune, 2009. "Price and quality in spatial competition," CEPR Discussion Papers 7422, C.E.P.R. Discussion Papers.
  12. Kurt R. Brekke & Robert Nuscheler & Odd Rune Straume, 2006. "Quality and Location Choices under Price Regulation," Journal of Economics & Management Strategy, Wiley Blackwell, vol. 15(1), pages 207-227, 03.
  13. Michael Baye & Robert Maness & Steven Wiggins, 1997. "Demand systems and the true subindex of the cost of living for pharmaceuticals," Applied Economics, Taylor & Francis Journals, vol. 29(9), pages 1179-1190.
  14. F. Moscone & E. Tosetti, 2010. "Health expenditure and income in the United States," Health Economics, John Wiley & Sons, Ltd., vol. 19(12), pages 1385-1403, December.
  15. Gravelle, Hugh & Masiero, Giuliano, 2000. "Quality incentives in a regulated market with imperfect information and switching costs: capitation in general practice," Journal of Health Economics, Elsevier, vol. 19(6), pages 1067-1088, November.
  16. Grytten, Jostein & Sorensen, Rune, 2003. "Practice variation and physician-specific effects," Journal of Health Economics, Elsevier, vol. 22(3), pages 403-418, May.
  17. H. Kelejian, Harry & Prucha, Ingmar R., 2001. "On the asymptotic distribution of the Moran I test statistic with applications," Journal of Econometrics, Elsevier, vol. 104(2), pages 219-257, September.
  18. Kelejian, Harry H & Prucha, Ingmar R, 1998. "A Generalized Spatial Two-Stage Least Squares Procedure for Estimating a Spatial Autoregressive Model with Autoregressive Disturbances," The Journal of Real Estate Finance and Economics, Springer, vol. 17(1), pages 99-121, July.
  19. Frank Windmeijer & Eric de Laat & Rudy Douven & Esther Mot, 2006. "Pharmaceutical promotion and GP prescription behaviour," Health Economics, John Wiley & Sons, Ltd., vol. 15(1), pages 5-18.
  20. Markus Herrmann, 2009. "Monopoly Pricing of an Antibiotic Subject to Bacterial Resistance," Cahiers de recherche 0946, CIRPEE.
  21. Moscone, F. & Tosetti, E., 2010. "Testing for error cross section independence with an application to US health expenditure," Regional Science and Urban Economics, Elsevier, vol. 40(5), pages 283-291, September.
  22. 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.
  23. Fredrik Carlsen & Jostein Grytten, 1998. "More physicians: improved availability or induced demand?," Health Economics, John Wiley & Sons, Ltd., vol. 7(6), pages 495-508.
  24. Kapoor, Mudit & Kelejian, Harry H. & Prucha, Ingmar R., 2007. "Panel data models with spatially correlated error components," Journal of Econometrics, Elsevier, vol. 140(1), pages 97-130, September.
  25. Filippini, Massimo & Masiero, Giuliano & Moschetti, Karine, 2009. "Small area variations and welfare loss in the use of outpatient antibiotics," Health Economics, Policy and Law, Cambridge University Press, vol. 4(01), pages 55-77, January.
  26. Filippini, M. & Masiero, G. & Moschetti, K., 2009. "Regional consumption of antibiotics: A demand system approach," Economic Modelling, Elsevier, vol. 26(6), pages 1389-1397, November.
Full references (including those not matched with items on IDEAS)

This item is not listed on Wikipedia, on a reading list or among the top items on IDEAS.

When requesting a correction, please mention this item's handle: RePEc:lug:wcepra:1302. See general information about how to correct material in RePEc.

For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: (Alessio Tutino)

If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

If references are entirely missing, you can add them using this form.

If the full references list an item that is present in RePEc, but the system did not link to it, you can help with this form.

If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your profile, as there may be some citations waiting for confirmation.

Please note that corrections may take a couple of weeks to filter through the various RePEc services.

This information is provided to you by IDEAS at the Research Division of the Federal Reserve Bank of St. Louis using RePEc data.