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Antibiotic consumption and the role of dispensing physicians

Author

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  • 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)

Abstract

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.

Suggested Citation

  • Massimo Filippini & Fabian Heimsch & Giuliano Masiero, 2013. "Antibiotic consumption and the role of dispensing physicians," CEPRA working paper 1302, USI Università della Svizzera italiana.
  • Handle: RePEc:lug:wcepra:1302
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    References listed on IDEAS

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    Cited by:

    1. Boris Kaiser & Christian Schmid, 2013. "Does Physician Dispensing Increase Drug Expenditures?," Diskussionsschriften dp1303, Universitaet Bern, Departement Volkswirtschaft.

    More about this item

    Keywords

    Physician dispensing; Prescribing behaviour; Antibiotic use;

    JEL classification:

    • I11 - Health, Education, and Welfare - - Health - - - Analysis of Health Care Markets
    • I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health
    • D12 - Microeconomics - - Household Behavior - - - Consumer Economics: Empirical Analysis
    • D21 - Microeconomics - - Production and Organizations - - - Firm Behavior: Theory
    • D43 - Microeconomics - - Market Structure, Pricing, and Design - - - Oligopoly and Other Forms of Market Imperfection
    • D81 - Microeconomics - - Information, Knowledge, and Uncertainty - - - Criteria for Decision-Making under Risk and Uncertainty
    • D82 - Microeconomics - - Information, Knowledge, and Uncertainty - - - Asymmetric and Private Information; Mechanism Design

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