Please use this identifier to cite or link to this item: https://hdl.handle.net/10419/262042 
Year of Publication: 
2022
Series/Report no.: 
IFN Working Paper No. 1428
Publisher: 
Research Institute of Industrial Economics (IFN), Stockholm
Abstract: 
We analyze changes in the willingness to substitute from prescribed pharmaceuticals to more affordable generic equivalents in response to the first experience with a substitution. Using Swedish individual-level data of prescribed and dispensed pharmaceuticals, we employ a dynamic event study and an instrumental variable approach to show that an initial substitution reduces the probability of opposing subsequent substitutions by 39 percentage points. The impact of a first substitution is especially large among elderly patients. We recommend that policy-makers target patients with a history of opposed substitution and offer additional discounts to promote substitution as long-term savings outweigh one-time costs.
Subjects: 
Generic Substitution
Pharmaceuticals
Health Care Costs
JEL: 
D12
I11
I12
Document Type: 
Working Paper

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