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CINCH - Health Economics Research Center

Monday Health Economics Seminar

30.01.2019

On Monday, February 4 2019, 14:00 - 15:30, Olivia Bodnar (DICE) will present:

Physician Dispensing and Drug Expenditures: Empirical Evidence from the NHS

While most OECD countries fully prohibit physician dispensing, there are some exceptions as, for example, in Japan, Switzerland, and the UK and lately also politically discussed in Germany. On the one hand, dispensing physicians may be incentivized to increase their profits through overprescribing or cost-inefficient prescribing. On the other hand, wholesale margins are higher for more competitive markets which could lead to a positive association between physician dispensing and the use of generic drugs. We evaluate drug dispensing by physicians in the National Health Service (NHS) in England between 2012 and 2017. We estimate average treatment effects (ATE), as well as marginal treatment effects (MTE) in order to identify a continuum of treatment effects along the distribution of individual unobserved characteristics that drive the treatment decision. We use quarterly prescription data from all general practitioners in the NHS from January 2012 to December 2017. Our first estimates suggest that drug dispensing increases expenditures per patient by 15,68 pounds sterling per year. This effect is mainly driven by an increase in the number of prescribed items. Furthermore, we observe substitution to smaller package sizes due to a fixed-fee payment for each dispensed item.

Room: WST-C.02.12, Weststadttürme Berliner Platz 6-8, Essen

To find more on upcoming seminars, click here.


Monday Health Economics Seminar

22.01.2019

On Monday, January 28 2019, 14:00 - 15:30 Sebastian Fleitas (KU Leuven) will present:

Dynamic Competition and Price Regulation when Consumers Have Inertia: Evidence from Medicare Part D

When consumer choices have inertia, firms have incentives to use dynamic pricing by first reducing the price to build a large market share, and then by increasing prices. This strategy may reduce consumer welfare through increases in the prices for incumbents, while also changing the patterns of entry and exit in the market. Although the presence of inertia in health care markets has been well established, little is known about the welfare implications of dynamic pricing in these markets. In order to assess these implications, in this paper I develop and estimate a dynamic model of supply and demand for Medicare Part D prescription drug insurance plans, where multi-product firms consider consumer inertia in their decisions about premiums, o fferings of new plans, and exit of plans. Using the model and the estimated parameters, I conduct counterfactual exercises where I explore the welfare e ffects of a policy that limits dynamic pricing by imposing fixed markups. I find that this policy, given the actual consumer inertia present in this market, would improve consumer welfare by 3.1%, through a reduction in premiums that is partially o ff-set by a reduction of entry into the market. When the same policy is implemented in a counterfactual scenario without inertia, it has a larger positive e ffect, increasing consumer welfare by 9.4% relative to the benchmark. This di erence indicates that policies that limit dynamic pricing can be more eff ective in improving consumer welfare in markets with lower levels of consumer inertia, where they are less likely to harm market entry.

Room: WST-C.02.12, Weststadttürme Berliner Platz 6-8, Essen

To find more on upcoming seminars, click here.


Monday Health Economics Seminar

16.01.2019

On Monday, January 21 2019, 14:00-15:30, Nina Schwarz (University of Duisburg-Essen) will present:

Sewerage Systems and the Infant Welfare Movement - Effects on Infant Mortality in Prussia

We analyse the impact of sewerage systems in Prussia on infant mortality by marital status of the mother. Using purposely digitised information on canalisations and administrative data on infant mortality, we find that the introduction of sewerage systems reduced infant mortality rates among children born out of wedlock by 12.5 deaths per 1,000 live births (12.7 per cent). For in-wedlock births, the reduction is one order of magnitude smaller; which suggests that canalisations contributed to a reduction in the socioeconomic gradient in child health. We further consider complementarities with milk depots, another public health intervention introduced in cities at around the same time, and find that the two interventions reinforced each other in their effects on infant health

Room: WST-C.02.12, Weststadttürme Berliner Platz 6-8, Essen

To find more on upcoming seminars, click here.