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How to Curb Over-The-Counter Sales of Antibiotics? Evidence from a Field Experiment in Ethiopia

Author

Listed:
  • Maria Vittoria Levati

    (Department of Economics (University of Verona))

  • Ivan Soraperra

    (Department of Economics (University of Verona))

  • Saba Yifredew

    (Addis Ababa University)

Abstract

In a randomized controlled trial among Addis Ababa's community pharmacies, we implement informational interventions to curb over-the-counter (OTC) antibiotic sales, which, especially in developing countries, contribute to the development of antimicrobial resistance (AMR). Our results show that one-time letters to pharmacists and a poster placed within the pharmacy premises significantly reduce OTC antibiotic sales in the short-run, with the poster's effect persisting five months later. We observe no significant impact on antibiotic prices. These findings highlight the potential of targeted informational interventions to tackle OTC antibiotic dispensing and mitigate the growing AMR threat.

Suggested Citation

  • Maria Vittoria Levati & Ivan Soraperra & Saba Yifredew, 2023. "How to Curb Over-The-Counter Sales of Antibiotics? Evidence from a Field Experiment in Ethiopia," Working Papers 10/2023, University of Verona, Department of Economics.
    • Handle: RePEc:ver:wpaper:10/2023
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    References listed on IDEAS

    as
    1. Currie, Janet & Lin, Wanchuan & Zhang, Wei, 2011. "Patient knowledge and antibiotic abuse: Evidence from an audit study in China," Journal of Health Economics, Elsevier, vol. 30(5), pages 933-949.
    2. Beshears, John & Choi, James J. & Laibson, David & Madrian, Brigitte C., 2013. "Simplification and saving," Journal of Economic Behavior & Organization, Elsevier, vol. 95(C), pages 130-145.
    3. Heather Royer & Mark Stehr & Justin Sydnor, 2015. "Incentives, Commitments, and Habit Formation in Exercise: Evidence from a Field Experiment with Workers at a Fortune-500 Company," American Economic Journal: Applied Economics, American Economic Association, vol. 7(3), pages 51-84, July.
    4. Ferraro, Paul J. & Miranda, Juan José, 2013. "Heterogeneous treatment effects and mechanisms in information-based environmental policies: Evidence from a large-scale field experiment," Resource and Energy Economics, Elsevier, vol. 35(3), pages 356-379.
    5. Uri Gneezy & Agne Kajackaite & Joel Sobel, 2018. "Lying Aversion and the Size of the Lie," American Economic Review, American Economic Association, vol. 108(2), pages 419-453, February.
    6. Adam Sacarny & David Yokum & Shantanu Agrawal, 2017. "Government-Academic Partnerships in Randomized Evaluations: The Case of Inappropriate Prescribing," American Economic Review, American Economic Association, vol. 107(5), pages 466-470, May.
    7. Chakravarty, Sujoy & Mishra, Rajan, 2019. "Using social norms to reduce paper waste: Results from a field experiment in the Indian Information Technology sector," Ecological Economics, Elsevier, vol. 164(C), pages 1-1.
    8. Irene Mussio & Angela C. M. Oliveira, 2022. "An (un)healthy social dilemma: a normative messaging field experiment with flu vaccinations," Health Economics Review, Springer, vol. 12(1), pages 1-16, December.
    9. Becchetti, Leonardo & Salustri, Francesco & Scaramozzino, Pasquale, 2020. "Nudging and corporate environmental responsibility: A natural field experiment," Food Policy, Elsevier, vol. 97(C).
    10. Bartling, Björn & Özdemir, Yagiz, 2023. "The limits to moral erosion in markets: Social norms and the replacement excuse," Games and Economic Behavior, Elsevier, vol. 138(C), pages 143-160.
    11. Köbis, Nils C. & Troost, Marleen & Brandt, Cyril O. & Soraperra, Ivan, 2022. "Social norms of corruption in the field: social nudges on posters can help to reduce bribery," Behavioural Public Policy, Cambridge University Press, vol. 6(4), pages 597-624, October.
    12. Dreber, Anna & Johannesson, Magnus, 2008. "Gender differences in deception," Economics Letters, Elsevier, vol. 99(1), pages 197-199, April.
    13. Allcott, Hunt, 2011. "Social norms and energy conservation," Journal of Public Economics, Elsevier, vol. 95(9-10), pages 1082-1095, October.
    14. Brañas-Garza, Pablo & Capraro, Valerio & Rascón-Ramírez, Ericka, 2018. "Gender differences in altruism on Mechanical Turk: Expectations and actual behaviour," Economics Letters, Elsevier, vol. 170(C), pages 19-23.
    15. Wang, Jing & Gong, Yanhong & Wu, Jianxiong & Jiang, Nan & Chen, Zhenyuan & Yin, Xiaoxv, 2021. "Antibiotic dispensing patterns and patient interventions for upper respiratory tract infections by hospitals and retail pharmacies: A cross-sectional study based on standardized patients," Social Science & Medicine, Elsevier, vol. 272(C).
    16. Hallsworth, Michael & List, John A. & Metcalfe, Robert D. & Vlaev, Ivo, 2017. "The behavioralist as tax collector: Using natural field experiments to enhance tax compliance," Journal of Public Economics, Elsevier, vol. 148(C), pages 14-31.
    17. Stephan Meier, 2007. "Do Subsidies Increase Charitable Giving in the Long Run? Matching Donations in a Field Experiment," Journal of the European Economic Association, MIT Press, vol. 5(6), pages 1203-1222, December.
    18. Houser, Daniel & Vetter, Stefan & Winter, Joachim, 2012. "Fairness and cheating," European Economic Review, Elsevier, vol. 56(8), pages 1645-1655.
    19. Felix Gottschalk & Wanda Mimra & Christian Waibel, 2020. "Health Services as Credence Goods: a Field Experiment," Post-Print hal-03137768, HAL.
    20. Gary Charness & Uri Gneezy, 2009. "Incentives to Exercise," Econometrica, Econometric Society, vol. 77(3), pages 909-931, May.
    21. David Bilén & Anna Dreber & Magnus Johannesson, 2021. "Are women more generous than men? A meta-analysis," Journal of the Economic Science Association, Springer;Economic Science Association, vol. 7(1), pages 1-18, September.
    22. Felix Gottschalk & Wanda Mimra & Christian Waibe, 2020. "Health Services as Credence Goods: a Field Experiment," The Economic Journal, Royal Economic Society, vol. 130(629), pages 1346-1383.
    23. Hunt Allcott & Todd Rogers, 2014. "The Short-Run and Long-Run Effects of Behavioral Interventions: Experimental Evidence from Energy Conservation," American Economic Review, American Economic Association, vol. 104(10), pages 3003-3037, October.
    24. Rajiv Sharma & Sarah Tinkler & Arnab Mitra & Sudeshna Pal & Raven Susu‐Mago & Miron Stano, 2018. "State Medicaid fees and access to primary care physicians," Health Economics, John Wiley & Sons, Ltd., vol. 27(3), pages 629-636, March.
    25. Allcott, Hunt, 2011. "Social norms and energy conservation," Journal of Public Economics, Elsevier, vol. 95(9), pages 1082-1095.
    26. Goel, P. & Ross-Degnan, D. & Berman, P. & Soumerai, S., 1996. "Retail pharmacies in developing countries: A behavior and intervention framework," Social Science & Medicine, Elsevier, vol. 42(8), pages 1155-1161, April.
    27. Ahomäki, Iiro & Pitkänen, Visa & Soppi, Aarni & Saastamoinen, Leena, 2020. "Impact of a physician-targeted letter on opioid prescribing," Journal of Health Economics, Elsevier, vol. 72(C).
    28. Jishnu Das & Alaka Holla & Aakash Mohpal & Karthik Muralidharan, 2016. "Quality and Accountability in Health Care Delivery: Audit-Study Evidence from Primary Care in India," American Economic Review, American Economic Association, vol. 106(12), pages 3765-3799, December.
    29. Currie, Janet & Lin, Wanchuan & Meng, Juanjuan, 2014. "Addressing antibiotic abuse in China: An experimental audit study," Journal of Development Economics, Elsevier, vol. 110(C), pages 39-51.
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    More about this item

    Keywords

    Antimicrobial resistance; OTC antibiotics; Field experiment; Community pharmacies; Simulated patients;
    All these keywords.

    JEL classification:

    • C93 - Mathematical and Quantitative Methods - - Design of Experiments - - - Field Experiments
    • I12 - Health, Education, and Welfare - - Health - - - Health Behavior
    • I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health
    • C21 - Mathematical and Quantitative Methods - - Single Equation Models; Single Variables - - - Cross-Sectional Models; Spatial Models; Treatment Effect Models

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