IDEAS home Printed from https://ideas.repec.org/p/tse/wpaper/128309.html
   My bibliography  Save this paper

Antibiotic Demand in the Presence of Antimicrobial Resistance

Author

Listed:
  • Dubois, Pierre
  • Gokkoca, Gokce

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

  • Dubois, Pierre & Gokkoca, Gokce, 2023. "Antibiotic Demand in the Presence of Antimicrobial Resistance," TSE Working Papers 23-1457, Toulouse School of Economics (TSE).
    • Handle: RePEc:tse:wpaper:128309
    as

    Download full text from publisher

    File URL: https://www.tse-fr.eu/sites/default/files/TSE/documents/doc/wp/2023/wp_tse_1457.pdf
    File Function: Full Text
    Download Restriction: no
    ---><---

    Other versions of this item:

    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. Reynaert, Mathias & Verboven, Frank, 2014. "Improving the performance of random coefficients demand models: The role of optimal instruments," Journal of Econometrics, Elsevier, vol. 179(1), pages 83-98.
    3. Nevo, Aviv, 2001. "Measuring Market Power in the Ready-to-Eat Cereal Industry," Econometrica, Econometric Society, vol. 69(2), pages 307-342, March.
    4. Laxminarayan, Ramanan & Brown, Gardner M., 2001. "Economics of Antibiotic Resistance: A Theory of Optimal Use," Journal of Environmental Economics and Management, Elsevier, vol. 42(2), pages 183-206, September.
    5. Jérôme Adda, 2020. "Preventing the Spread of Antibiotic Resistance," AEA Papers and Proceedings, American Economic Association, vol. 110, pages 255-259, May.
    6. Dubois, Pierre & Tunçel, Tuba, 2021. "Identifying the effects of scientific information and recommendations on physicians’ prescribing behavior," Journal of Health Economics, Elsevier, vol. 78(C).
    7. Toshiaki Iizuka, 2007. "Experts' agency problems: evidence from the prescription drug market in Japan," RAND Journal of Economics, RAND Corporation, vol. 38(3), pages 844-862, September.
    8. 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(1), pages 55-77, January.
    9. Steven T. Berry, 1994. "Estimating Discrete-Choice Models of Product Differentiation," RAND Journal of Economics, The RAND Corporation, vol. 25(2), pages 242-262, Summer.
    10. Ramanan Laxminarayan & Thomas Van Boeckel & Aude Teillant, 2015. "The Economic Costs of Withdrawing Antimicrobial Growth Promoters from the Livestock Sector," OECD Food, Agriculture and Fisheries Papers 78, OECD Publishing.
    11. Daniel Bennett & Che-Lun Hung & Tsai-Ling Lauderdale, 2015. "Health Care Competition and Antibiotic Use in Taiwan," Journal of Industrial Economics, Wiley Blackwell, vol. 63(2), pages 371-393, June.
    12. Chamberlain, Gary, 1987. "Asymptotic efficiency in estimation with conditional moment restrictions," Journal of Econometrics, Elsevier, vol. 34(3), pages 305-334, March.
    13. David H. Howard, 2004. "Resistance‐induced antibiotic substitution," Health Economics, John Wiley & Sons, Ltd., vol. 13(6), pages 585-595, June.
    14. Farasat A.S. Bokhari & Franco Mariuzzo & Weijie Yan, 2019. "Antibacterial resistance and the cost of affecting demand: the case of UK antibiotics," Working Paper series, University of East Anglia, Centre for Competition Policy (CCP) 2019-03, Centre for Competition Policy, University of East Anglia, Norwich, UK..
    15. Papke, Leslie E & Wooldridge, Jeffrey M, 1996. "Econometric Methods for Fractional Response Variables with an Application to 401(K) Plan Participation Rates," Journal of Applied Econometrics, John Wiley & Sons, Ltd., vol. 11(6), pages 619-632, Nov.-Dec..
    16. Derek R. MacFadden & Sarah F. McGough & David Fisman & Mauricio Santillana & John S. Brownstein, 2018. "Antibiotic resistance increases with local temperature," Nature Climate Change, Nature, vol. 8(6), pages 510-514, June.
    17. Thomas Heister & Christian Hagist & Klaus Kaier, 2017. "Resistance Elasticity of Antibiotic Demand in Intensive Care," Health Economics, John Wiley & Sons, Ltd., vol. 26(7), pages 892-909, July.
    18. Simpkin, Victoria L. & Renwick, Matthew J. & Kelly, Ruth & Mossialos, Elias, 2017. "Incentivising innovation in antibiotic drug discovery and development: progress, challenges and next steps," LSE Research Online Documents on Economics 86434, London School of Economics and Political Science, LSE Library.
    19. 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.
    Full references (including those not matched with items on IDEAS)

    Citations

    Citations are extracted by the CitEc Project, subscribe to its RSS feed for this item.
    as


    Cited by:

    1. 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).
    2. 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.

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Bokhari, Farasat A.S. & Mariuzzo, Franco & Yan, Weijie, 2024. "Antibacterial resistance and the cost of affecting demand: The case of UK antibiotics," International Journal of Industrial Organization, Elsevier, vol. 95(C).
    2. Farasat A.S. Bokhari & Franco Mariuzzo & Weijie Yan, 2019. "Antibacterial resistance and the cost of affecting demand: the case of UK antibiotics," Working Paper series, University of East Anglia, Centre for Competition Policy (CCP) 2019-03, Centre for Competition Policy, University of East Anglia, Norwich, UK..
    3. Suppliet, Moritz, 2020. "Umbrella branding in pharmaceutical markets," Journal of Health Economics, Elsevier, vol. 73(C).
    4. Limin Fang, 2022. "The Effects of Online Review Platforms on Restaurant Revenue, Consumer Learning, and Welfare," Management Science, INFORMS, vol. 68(11), pages 8116-8143, November.
    5. Wang, Ao, 2021. "A BLP Demand Model of Product-Level Market Shares with Complementarity," The Warwick Economics Research Paper Series (TWERPS) 1351, University of Warwick, Department of Economics.
    6. Matthew Backus & Christopher Conlon & Michael Sinkinson, 2021. "Common Ownership and Competition in the Ready-to-Eat Cereal Industry," NBER Working Papers 28350, National Bureau of Economic Research, Inc.
    7. Shan Huang & Hannes Ullrich, 2023. "Provider effects in antibiotic prescribing: Evidence from physician exits," Berlin School of Economics Discussion Papers 0018, Berlin School of Economics.
    8. Escobari, Diego, 2017. "Airport, airline and departure time choice and substitution patterns: An empirical analysis," Transportation Research Part A: Policy and Practice, Elsevier, vol. 103(C), pages 198-210.
    9. Dubois, Pierre & Majewska, Gosia, 2022. "Mergers and Advertising in the Pharmaceutical Industry," TSE Working Papers 22-1380, Toulouse School of Economics (TSE).
    10. Ligthart, Jenny E. & Werner, Sebastian E.V., 2012. "Has the euro affected the choice of invoicing currency?," Journal of International Money and Finance, Elsevier, vol. 31(6), pages 1551-1573.
    11. Jan De Loecker & Paul T. Scott, 2016. "Estimating market power Evidence from the US Brewing Industry," NBER Working Papers 22957, National Bureau of Economic Research, Inc.
    12. Sebastian Panthöfer, 2022. "Do doctors prescribe antibiotics out of fear of malpractice?," Journal of Empirical Legal Studies, John Wiley & Sons, vol. 19(2), pages 340-381, June.
    13. Ivan Moreno-Torres, 2011. "Generic drugs in Spain: price competition vs. moral hazard," Working Papers XREAP2011-04, Xarxa de Referència en Economia Aplicada (XREAP), revised May 2011.
    14. Keith Head & Thierry Mayer, 2021. "Poor Substitutes? Counterfactual methods in IO and Trade compared," Working Papers 2021-11, CEPII research center.
    15. Zhu, Chen & Lopez, Rigoberto A. & Liu, Xiaoou, 2019. "Consumer responses to front-of-package labeling in the presence of information spillovers," Food Policy, Elsevier, vol. 86(C), pages 1-1.
    16. In Kyung Kim & Kyoo il Kim, 2022. "No Beer No Friends: Quantifying the Effect of the Beer Boycott," Journal of Industrial Economics, Wiley Blackwell, vol. 70(3), pages 711-751, September.
    17. Ivan Moreno-Torres, 2011. "What if there was a stronger pharmaceutical price competition in Spain? When regulation has a similar effect to collusion," Working Papers XREAP2011-02, Xarxa de Referència en Economia Aplicada (XREAP), revised May 2011.
    18. Reynaert, Mathias & Verboven, Frank, 2014. "Improving the performance of random coefficients demand models: The role of optimal instruments," Journal of Econometrics, Elsevier, vol. 179(1), pages 83-98.
    19. Mogens Fosgerau & Julien Monardo & André de Palma, 2024. "The Inverse Product Differentiation Logit Model," American Economic Journal: Microeconomics, American Economic Association, vol. 16(4), pages 329-370, November.
    20. Claudio Deiana & Ludovica Giua & Roberto Nisticò, 2019. "The Economics Behind the Epidemic: Afghan Opium Price and Prescription Opioids in the US," CSEF Working Papers 525, Centre for Studies in Economics and Finance (CSEF), University of Naples, Italy, revised 13 May 2019.

    More about this item

    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

    NEP fields

    This paper has been announced in the following NEP Reports:

    Statistics

    Access and download statistics

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:tse:wpaper:128309. See general information about how to correct material in RePEc.

    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 CitEc recognized a bibliographic reference but did not link an item in RePEc 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 RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: the person in charge (email available below). General contact details of provider: https://edirc.repec.org/data/tsetofr.html .

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

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.