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英文文献：Piling Pills? Forward-Looking Behavior and Stockpiling of Prescription Drugs-打桩药片吗?前瞻行为和处方药储备
英文文献作者：Marianne Simonsen,Lars Skipper,Niels Skipper
英文文献摘要：
This paper provides evidence of forward-looking behavior in the demand for prescription drugs, while relying on registry-based, individual-level information about the universe of Danish prescription drug purchases from 1995–2014. We exploit a universal shift in policy in early 2000 from a flat-rate to a non-linear insurance plan for prescription drugs that incentivizes stockpiling at the end of the coverage year. We extend the original framework of Keeler et al. (1977) and discuss how the institutional features of most health insurance contracts, at least theoretically, incentivize intertemporal substitution in purchases across coverage years. We describe how consumers react to the introduction of the non-linear plan by increasing spending by 80% immediately before the implementation of the new regime. Next, our main analysis takes advantage of the policy experiment to formally analyze behavior immediately prior to the end-of-year reset in the non-linear plan using a difference-in-difference strategy. We provide evidence that consumers react to this reset by stockpiling toward the end of the coverage year: consumers buy what amounts to an additional 20%. We detect heterogeneity in the size of the response by individual-level characteristics, proxies for health status, and drug type. We find no evidence of any immediate adverse health utilization effects associated with the stockpiling. We round off the paper with an analysis of the importance of stockpiling for estimates of price sensitivity. We find that ignoring intertemporal substitution across coverage years inflates price sensitivity estimates by a non-negligible amount.
本文依据1995-2014年丹麦处方药购买领域基于注册的、个人层面的信息，为处方药需求中的前瞻性行为提供了证据。我们在2000年初实现了政策的全面转变，从统一费率到非线性的处方药保险计划，鼓励在覆盖年度结束时囤积药品。我们扩展了Keeler等人(1977)的原始框架，并讨论了大多数健康保险合同的制度特征(至少在理论上)如何激励跨覆盖年购买的跨期替代。我们描述了消费者对引入非线性计划的反应，即在新制度实施前增加80%的支出。接下来，我们的主要分析利用政策实验来正式分析非线性计划中使用差异中差异策略的年末重置前的行为。我们提供的证据表明，消费者对这种重新调整的反应是在保险年度结束前囤积:消费者会购买相当于额外20%的保险。我们通过个体水平特征、健康状况代理和药物类型来检测反应大小的异质性。我们没有发现任何证据表明与储存有关的任何对健康利用的直接不利影响。最后，我们分析了库存对估计价格敏感性的重要性。我们发现，忽略跨覆盖年的跨时间替代会使价格敏感性估计值以不可忽略的数量膨胀。
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