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CINCH - Health Economics Research Center

Essen Health Economics Seminar @ CINCH Essen

28.05.2019

On Monday, June 3 2019, 14:00 - 15:30, Benjamin Birkner (HCHE, University of Hamburg) and Katharina Blankart (CINCH, University of Duisburg-Essen) will present:

The Impact of Regional Physician Association Regulations on the Biosimilar Prescription Behaviour in Germany

Introduction

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.

Methods

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.

Results

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.

Discussion

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

To find more on upcoming seminars, click here.


Essen Health Economics Seminar @ RWI Essen

15.05.2019

On Monday, May 20 2019, 14:00 - 15:30, Christiane Wuckel (RWI Essen) will present:

Teenage suicides: Does school kill?

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.

Room: E-Werk, RWI Essen, Hohenzollernstrasse 1-3, 45128 Essen

To find more on upcoming seminars, click here.


Essen Health Economics Seminar @ CINCH Essen

08.05.2019

On Monday, May 13 2019, 14:00 - 15:30, Rob Pryce (Sheffield University) will present:

The Effect of the United Kingdom Smoking Ban on Alcohol Spending

The effect of smoking bans on alcohol consumption is unclear, and this is especially true of the differing effect on smokers and nonsmokers. This paper uses spending survey data to examine the effect of the United Kingdom smoking bans on alcohol spending. It finds the introduction of a smoking ban decreased alcohol expenditure, specifically in the on-trade (pubs and restaurants) and amongst smokers. This was not compensated for through an increase in alcohol expenditure amongst non-smokers. The smoking ban may have affected on-premise outlets through a reduction in revenue. Tobacco and alcohol policies should not be evaluated in isolation, as these are joint behaviours and a change in policy affecting one behaviour will have effects on the other.

Room: WST-A.02.04, Weststadttürme Berliner Platz 6-8, Essen

To find more on upcoming seminars, click here.