Are physicians' prescribing decisions sensitive to drug prices? Evidence from a free-antibiotics program

Health Econ. 2015 Feb;24(2):158-74. doi: 10.1002/hec.3008. Epub 2013 Oct 25.

Abstract

This paper investigates whether patient-level factors, in particular cost considerations, affect the physicians' prescribing decisions. In the context of a natural experiment, we examine the effect of the first US commercial free-antibiotics program on retail antibiotic sales. We find an overall increase in antibiotic prescriptions under the program and substitutions to covered antibiotics from not-covered antibiotics. The shift away from not-covered antibiotics, particularly from those without covered equivalents, indicates a change in the physicians' prescribing decisions. We locate stronger program effects in low-income areas. Our findings, robust to a variety of specifications, are in contrast with previous literature.

Keywords: antibiotics; natural experiment; prescribing decisions.

MeSH terms

  • Anti-Bacterial Agents / administration & dosage*
  • Anti-Bacterial Agents / economics*
  • Decision Making*
  • Drug Utilization / economics*
  • Fees, Pharmaceutical / statistics & numerical data*
  • Health Knowledge, Attitudes, Practice
  • Humans
  • Income / statistics & numerical data
  • Insurance Claim Review
  • Models, Statistical
  • Practice Patterns, Physicians' / statistics & numerical data*
  • United States

Substances

  • Anti-Bacterial Agents