Does Physician Dispensing Increase Drug Expenditures? Empirical Evidence from Switzerland

Kaiser, Boris; Schmid, Christian

doi:10.1002/hec.3124

Cited by 33 publications

(40 citation statements)

References 34 publications

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“…Collectively, over-prescribing raised consultation costs through an increase in the total time of treatment. Therefore, the authors concluded that dispensing by physicians clearly affects health care expenditures hence placing an additional burden on the patients and healthcare system [2]. In line to what is reported earlier, Beck et al by using the canton-level data reported that physician dispensing considerably increases drug expenditures [15].…”

Section: Dispensing Separation and Medication Costmentioning

confidence: 67%

“…Inline to the inefficiencies of the healthcare systems around the globe, dispensing separation has been a topic of thoughtful interest in the literature [2][3][4][5][6]. While some countries allow physicians to dispense medicines, a number of OECD (Organization for Economic Co-operation and Development) countries have fully banned physician dispensing of medications to the patients [2].…”

Section: Introductionmentioning

confidence: 99%

“…Where prescribing is exclusively attributed to physicians, dispensing of medications is an integral service linked to the pharmacists [8]. This clear demarcation of dispensing roles avoid conflicts as physicians are incentivized to encourage demand or substitute more expensive medicines because of substantial profit margin on medication sales [2,9]. Furthermore, the separation of roles augments sagacity of treatment, as pharmacists being the medicine specialists receive, review and deliver prescriptions that safeguards good dispensing practices [8].…”

Section: Introductionmentioning

confidence: 99%

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Public Perceptions towards Implementation of Dispensing Separation: Results from a Cross Sectional Analysis

Hassali¹,

Saleem²,

Aljadhey³

2015

J Pharma Care Health Sys

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The Malaysian healthcare system has yet to introduce a legislature that implements separation of physicians and pharmacists roles. More recently, a proposal was offered to take the Malaysian populations point of view towards dispensing separation. Therefore, the current study is aimed to assess general public perceptions towards implementation of dispensing separation in the state of Penang, Malaysia. A cross-sectional study design was adopted to conduct the study. A pre-validated questionnaire was offered to 1000 residents in the state of Penang, Malaysia. Both descriptive and inferential statistics were used for data explanation. SPSS® v 22.0 was used for data analysis. The level of statistical significance was taken to be p < 0.05. Sixty-three percent of the respondents were females with Malay being the prevailing ethnic group (n = 527, 52.7%). Seven hundred and sixteen (71.6%) of the respondents reported pharmacists as a reliable source of medicine-related information when compared with physicians provided when diagnosis has been made. Majority of the respondents (n = 876, 87.6%) assured their support towards implementation of dispensing separation in Malaysia. The respondents explained that dispensing separation will result in optimization of patient safety (n = 890, 89.0%), help in to reduce medication error (877, 87.7%) and will reduce the cost of medication (n = 777, 77.7%). There was a significant association reported between supporting future implementation of dispensing separation and all demographic variables (p < 0.05). In addition, the all reported associated were positively and moderate in association (φc ranging from 0.288 -0.335). Results of the current study presented a strong evidence of public support and benefits of dispensing separation in Malaysia. These findings are of high relevance to the policy makers as it provides an over view of public choice of implementing dispensing separation in Malaysia.

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Section: Dispensing Separation and Medication Costmentioning

confidence: 67%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Public Perceptions towards Implementation of Dispensing Separation: Results from a Cross Sectional Analysis

Hassali¹,

Saleem²,

Aljadhey³

2015

J Pharma Care Health Sys

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“…Using physician-level data for the period 2008-10, and exploiting regional variation in dispensing regimes across cantons, Kaiser and Schmid (2013) show that dispensing physicians (40% of the total) increase drug costs per patient by 30%. However, several other studies have shown that self-dispensing doctors have a mitigating cost-saving effect by prescribing generics more frequently where their profit margins are higher (Rischatsch et al, 2009).…”

Section: Source: Oecd Health At a Glance 2015mentioning

confidence: 99%

Raising Public Spending Efficiency in Switzerland

Dutu

2016

OECD Economics Department Working Papers

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“…However, while the separation of prescription and sale of drugs is suitable in most regions, factors such as geography or population density can justify self-dispensation. Even though self-dispensation has been shown to potentially increase general drug expenditures (Kaiser and Schmid, 2015), the aim to ensure optimal medical and pharmaceutical coverage can weigh higher than the additional costs. Though it may help particular regions to allow for self-dispensing physicians, it is obvious that a single person who pools complex competences is a second-best solution to two distinct specialists: a pharmacist with her background in chemistry and pharmacy and a doctor with her background in medicine.…”

Section: Introductionmentioning

confidence: 99%

Ask Your Doctor or Pharmacist! On the Effect of Self-Dispensing Physicians on Pharmaceutical Coverage

Bannert

Iselin

2015

SSRN Journal

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Standard-Nutzungsbedingungen:Die Dokumente auf EconStor dürfen zu eigenen wissenschaftlichen Zwecken und zum Privatgebrauch gespeichert und kopiert werden.Sie dürfen die Dokumente nicht für öffentliche oder kommerzielle Zwecke vervielfältigen, öffentlich ausstellen, öffentlich zugänglich machen, vertreiben oder anderweitig nutzen.Sofern die Verfasser die Dokumente unter Open-Content-Lizenzen (insbesondere CC-Lizenzen) zur Verfügung gestellt haben sollten, gelten abweichend von diesen Nutzungsbedingungen die in der dort genannten Lizenz gewährten Nutzungsrechte. Terms of use: Documents in AbstractIn most developed countries drugs are dispensed to patients through physicians and pharmacists. This paper studies the effects of allowing doctors to directly dispense drugs to patients (self-dispensation) on pharmaceutical coverage. We use a Swiss dataset in our empirical analysis because Switzerland's federalist legislation allows us to study self-dispensing and non-self-dispensing regimes alike. We add location information obtained from Google Geocoding services to our dataset in order to measure coverage based on distances. To capture a driver of long term positioning decisions, we take revenues as a proxy for a pharmacy's usage rate.We find that, ceteris paribus, self-dispensation leads to a lowered regional density of pharmacies. By matching similar pharmacies across both regimes we find that revenues are substantially lower for pharmacies under a self-dispensation regime.Pharmacies in cantons that allow physicians to dispense drugs tend to have relatively higher revenues associated with non-drugs. We suggest to organize legislation on self-dispensation at a fine grained regional level as regional typologies are the most reasonable justification for regime choice.

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Does Physician Dispensing Increase Drug Expenditures? Empirical Evidence from Switzerland

Cited by 33 publications

References 34 publications

Public Perceptions towards Implementation of Dispensing Separation: Results from a Cross Sectional Analysis

Public Perceptions towards Implementation of Dispensing Separation: Results from a Cross Sectional Analysis

Raising Public Spending Efficiency in Switzerland

Ask Your Doctor or Pharmacist! On the Effect of Self-Dispensing Physicians on Pharmaceutical Coverage

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