Physician Dispensing in Switzerland - the Influence on Healthcare Expenditures

Universität Bayreuth

Rechts- und Wirtschaftswissenschaftliche Fakultät

Lehrstuhl für Volkswirtschaftslehre III

-  insb. Finanzwissenschaft –

Prof. Dr. Volker Ulrich

Essay

Physician dispensing in Switzerland

The influence on healthcare expenditures

vorgelegt von:                                                    Abgabedatum: 07.04.2017

Sebastian Kollmeier

Josephsplatz 3

95444 Bayreuth

s3sekoll@uni-bayreuth.de

Matrikelnummer: 1385194

Fachsemester 3

Gesundheitsökonomie M. Sc.

Table of Contents

1. Summary of the study        1

2. Discussion of the results        2

3. Relevance of physician dispensing in Switzerland        4

4. Conclusion for the German healthcare system        6

References        7

Ehrenwörtliche Erklärung        9

1. Summary of the study

The present study „Does physician dispensing increase drug expenditures? Empirical evidence from Switzerland“ by Boris Kaiser and Christian Schmid (two economists of the University of Bern who hold a doctorate in economics) analyzes how healthcare expenditures is influenced by physician dispensing through medical specialists in German-speaking Switzerland (cf. Kaiser / Schmid, 2016, p.71).

The data used in the study was made available by the operator of the nationwide database of Swiss health insurers (Sasis AG) and covers the years 2008-2010. This data set shows information on self-employed medical specialists who provide ambulatory care; general practitioners or psychiatrists are not part of the set and therefore such data is not included in the study (cf. Kaiser / Schmid, 2016, p.77 f.).

In order to compare expenditures induced by dispensing and non-dispensing physicians two factors of the total annual prescribing costs are observed separately. On the one hand the direct costs are examined that occur when physicians sell and distribute drugs directly to their patients, and on the other hand indirect costs are considered which occur when issuing a prescription that can be handed in at a pharmacy. This information also allows backtracking of the prescription drug sold in a pharmacy and its attributed costs to the physician who originally issued it. The two named aspects are crucial for the comparison between the costs of drugs prescribed by dispensing physicians and the costs of drugs prescribed by non-dispensing physicians. Furthermore, non-drug medical costs were monitored. This includes all remaining outpatient costs caused by physicians, mainly consultation and diagnostic costs (cf. Kaiser / Schmid, 2016, p.78).