The University of Tokyo, Bunkyo-ku, Tokyo.
Am Econ Rev. 2012 Oct;102(6):2826-58. doi: 10.1257/aer.102.6.2826.
I examine physician agency in health care services in the context of the choice between brand-name and generic pharmaceuticals. I examine micro-panel data from Japan, where physicians can legally make profits by prescribing and dispensing drugs. The results indicate that physicians often fail to internalize patient costs, explaining why cheaper generics are infrequently adopted. Doctors respond to markup differentials between the two versions, indicating another agency problem. However, generics’ markup advantages are short-lived, which limits their impact on increasing generic adoption. Additionally, state dependence and heterogeneous doctor preferences affected generics' adoption. Policy makers can target these factors to improve static efficiency.
我考察了在品牌药和仿制药之间的选择背景下，医生在医疗服务中的代理行为。我考察了来自日本的微观面板数据，在日本，医生可以通过开处方和配药来合法盈利。结果表明，医生往往不能将患者的成本内在化，这解释了为什么较便宜的仿制药很少被采用。医生对两种版本之间的差价做出反应，这表明存在另一个代理问题。然而，仿制药的加价优势是短暂的，这限制了它们对提高仿制药采用率的影响。此外，状态依存性和医生偏好的异质性也影响了仿制药的采用。政策制定者可以针对这些因素来提高静态效率。
