Physician altruism and moral hazard: (no) evidence from Finnish national prescriptions data
File(s)Finland paper 2018 November 26th_IL.docx (189.3 KB)
Accepted version
Author(s)
Crea, G
Galizzi, M
Linnosmaa, I
Miraldo, Marisa
Type
Journal Article
Abstract
We test the physicians’ altruism and moral hazard hypotheses using a national panel register containing all 2003–2010 statins prescriptions in Finland. We estimate the likelihood that physicians prescribe generic versus branded versions of statins as a function of the shares of the difference between what patients have to pay out of their pocket and what is covered by the insurance, controlling for patient, physician, and drug characteristics. We find that the estimated coefficients and the average marginal effects associated with moral hazard and altruism are nearly zero, and are orders of magnitude smaller than the ones associated with other explanatory factors such as the prescriptions’ year and the physician specialization. When the analysis distinctly accounts for both the patient and the insurer shares of expenditure, the estimated coefficients directly reject the altruism and moral hazard hypotheses. Instead, we find strong and robust evidence of habits persistence in prescribing branded drugs.
Date Issued
2019-05-01
Date Acceptance
2019-03-16
Citation
Journal of Health Economics, 2019, 65, pp.153-169
ISSN
0167-6296
Publisher
Elsevier
Start Page
153
End Page
169
Journal / Book Title
Journal of Health Economics
Volume
65
Copyright Statement
© 2019 Published by Elsevier B.V. This manuscript is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International Licence http://creativecommons.org/licenses/by-nc-nd/4.0/
Sponsor
National Institute for Health and Welfare (THL)
Grant Number
30121 DRUGA
Subjects
Habits persistence
Moral hazard
Pharmaceuticals
Physician altruism
1402 Applied Economics
1117 Public Health and Health Services
Health Policy & Services
Publication Status
Published
Date Publish Online
2019-03-16