On Monday, June 17 2019, 14:00 - 15:30, Anne-Laure Samson (Université de Lille) will present:
Parental Attitudes and Beliefs about Vaccines: Unexpected Effects of a Vaccination Campaign against Hepatitis B in France
We evaluate the impact of a French vaccination campaign against hepatitis B (HB) that took place in 1994. Using a regression discontinuity design, we show that this political measure created an exogenous shock on vaccination behaviors, increasing the vaccination rate against HB for children aged 11 and above. We also show that this vaccination scheme led to a decline in knowledge about the mode of transmission of the disease, confusion about the target population and, more importantly, a drop in measles, mumps, and rubella (MMR) vaccination rate. The effect on MMR vaccination was relatively unexpected and may imply a negative externality. Indeed, measles is an extremely contagious disease. If the vaccination rate falls, the disease will spread further, raising the question of the net effect of the HB vaccination campaign on the population well-being.
The Impact of Regional Physician Association Regulations on the Biosimilar Prescription Behaviour in Germany
Biosimilars are a less costly alternative to original biological drugs. Although only four percent of the insured receive biologics, they are responsible for 21 percent of drug expenditure. In addition, the proportion of biosimilar prescriptions in Germany varies greatly between regions. The aim of this analysis is to investigate the influence of the introduction of regulations (quotas, prioritized prescribing) by physician associations (PAs) on the prescribing behavior of physicians in Germany.
Our data consists of the drug agreements (Arzneimittelvereinbarungen) of the PAs and data sets of national outpatient services and prescription data for the period 2009-2015. We focus on the active substances somatropin, erythropoiesis stimulating agents (ESA) and filgrastim. Using a lagged-dependent variable approach, the prescribing behavior of physicians in PAs with regulation is compared with that of physicians in PAs without regulation. Outcome variables are the proportion of biosimilar prescriptions and the number of prescriptions of biologics and biosimilars. We control for regional differences as well as practice and patient characteristics.
On the one hand, we find positive effects for the frequently prescribed active substances ESA and filgrastim. On the other hand, physicians did not react to regulations for somatropin. Where significant effects were identified, the introduction of regulations increased the proportion of biosimilar prescriptions on average between 2.7 and 14 percentage points (p<0.01). Overall, a regionally heterogeneous picture emerges. For example, the number of prescriptions of original drugs decreases due to the introduction of the priority prescription in the PA Bremen, while opposite effects can be observed for the introduction of a quota in other PAs.
The effect of regulation on the prescribing behavior for biosimilars is not uniform. There were no clear effects of regulation depending on the introduction of explicit quotas or priority prescription requirements. Due to unobservable factors such as price reactions by manufacturers and individual discount agreements of insurers, it is not possible to determine the causal effect of the measures conclusively yet.
Room: WST-A.02.04, Weststadttürme Berliner Platz 6-8, Essen
Taking advantage of temporal and geographical variations in the timing of school holidays in Germany, this paper finds that school holidays cause a 18 percent decrease in the probability of youth suicide. This effect is constant across different types of holidays (fall, Christmas, winter, Easter, Pentecost and summer). Moreover, we find evidence of a spike in suicide propensity in the first two days following the end of school holidays. These results are robust to a series of control variables and to different definitions of youth. Overall, this paper suggests that school holidays have a beneficial impact on the well-being of students and that suicide prevention efforts are particularly important in the days following the end of holidays.