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Does Patient Demand Contribute to the Overuse of Prescription Drugs (English)

This study conducted an experiment in Mali to test whether patients pressure doctors to prescribe medical treatment they do not necessarily need. The experiment varied patients’ information about a discount for antimalarial tablets and measured demand for both tablets and costlier antimalarial injections. The study finds evidence of patient-driven demand: informing patients about the discount, instead of letting doctors decide to share this information, increased discount use by 35 percent and overall malaria treatment by 10 percent. These marginal patients rarely had malaria, worsening the illness-treatment match. Providers did not use the information advantage to sell injections -- their use fell in both information conditions.


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    Pereira Lopez,Carolina, Sautmann,Anja, Schaner,Simone Gabrielle

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    Policy Research Working Paper

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    The World Region,

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    Does Patient Demand Contribute to the Overuse of Prescription Drugs ?

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    public provision of health care; development research group; average per capita monthly income; Demographic and Health Survey; malaria treatment; severe malaria; demand for treatment; treatment for malaria; cost of treatment; rates of transmission; change in demand; standard of care; high parasite density; incentives for doctors; high malaria risk; primary care clinic; health worker training; revenue from sales; severe malaria cases; quality of care; average exchange rate; global health policy; lost future business; follow up survey; mother and child; deaths among children; data collection protocols; public health center; public health facility; public health system; access to life; per capita income; public sector provider; diagnosis and treatment; patient demand; Health Workers; treatment outcomes; treatment group; prescription drug; healthcare provider; clinic visit; low risk; medical treatment; malaria infection; malaria control; experimental design; sampling frame; demographic characteristic; combination therapy; patients present; blood sample; health clinic; health clinics; 0 hypothesis; expected utility; health association; recent work; test result; drug resistance; acute illness; severe anemia; study area; free treatment; accurate diagnosis; private information; government budget; Public Facilities; older individual; cation search; curative health; health good; preventive health; positive externality; large subsidy; negative externality; disease resistance; qualitative research; empirical result; saharan africa; delivery mechanism; cost control; public clinic; marginal change; renal failure; prescription rates; Public Healthcare; medical facility; rural area; medical doctor; recent progress; malaria symptom; retail price; voucher program; life-threatening complication; standard deviation; Learning and Innovation Credit; risk aversion; treatment policy; local ngo; health directorate; malaria diagnosis; sale price; intensive training; rainy season; collected information; administrative datum; Research Support; summary statistic; presumptive treatment; standard error; survey respondent; minor children; development policy; open access; information condition; mosquito net; patient characteristics; pregnancy status; antimalarial tablet; socio-economic status; linear regression; Health policies; subsidy policy; international consensus; resistant parasites; Price Subsidies; national policy; utility cost; prescription behavior; theoretical model; average cost; study period; falciparum malaria; consumer market; Pharmaceutical Industry; simple model; credit constraint; knowledge gap; low motivation



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Pereira Lopez,Carolina Sautmann,Anja Schaner,Simone Gabrielle

Does Patient Demand Contribute to the Overuse of Prescription Drugs (English). Policy Research working paper,no. WPS 9482 Washington, D.C. : World Bank Group.