SIHS SEMINAR Series

次回セミナー/Next Seminar

2026年10月1日(木)　October 1 (Thu.), 2026 5:20PM-6:50PM

報告者/Presenter: 井深陽子/Yoko Ibuka (慶応義塾大学/Keio University) 

Title: Paying More at Fixed Prices: Pharmacy Incentives and Drug Substitution (joint with Haruo Kakehi)   

場所：2号館11階経済学部会議室B

Venue: 11th Floor, Bldg. No.2 Meeting Room B 

幹事/Organizer：長谷部拓也/Takuya Hasebe 

言語/Language：英語/English 

要旨/Abstract: When regulated prices cannot clear shortages, non-price mechanisms determine who bears the cost. We study this in Japan’s drug market, where pharmacists choose among differently priced substitutes, exploiting a government-ordered suspension of a major generic manufacturer. Out-of-pocket spending rose by up to 21%, driven by temporary shifts to brand-name drugs and larger, persistent shifts to higher-priced generics. Pharmacists’ dispensing choices vary with financial incentives, yet the government’s pay-for-performance program rewards generic use rather than the use of lower-priced generics and cannot prevent within-generic cost increases. We evaluate targeted incentives that could reduce patient and total spending. We also find evidence of lower adherence and higher discontinuation, indicating disruptions to treatment continuity.