Sharing the Burden: The Impacts of Pharmacy Sector Reforms on the Labor Market for Pharmacists in Portugal
中文摘要
在2010年金融危机最严重之际，葡萄牙政府对处方药报销制度实施了一系列改革。此后三年间，零售药房中药剂师人均创造的增加值下降了三分之一，这反映了仿制药替代率上升以及处方药获准加价幅度的下降。这一巨大冲击导致在职药剂师薪资下调，并对新聘人员引入了双轨薪酬制，但就业增长几乎没有或完全没有放缓。我们使用Quadros de Pessoal数据库中的详细纵向记录，并将其与集体谈判协议和企业财务记录相匹配，以研究这些改革的影响。我们估计，2009年至2022年间，药剂师的平均工资下降了三分之一；其中大部分降幅源于新进入群体工资的降低。由此推算的工资对生产率的响应程度大幅高于租金分享文献中的多数估计，这可能反映了劳动者对该行业的强烈黏着，以及新毕业药剂师的持续流入。进一步地，我们随后考察了葡萄牙药剂师工资相对于其他医疗保健专业人员工资的分化情况，以及近期大学申请者选择进入该职业的决定。
Abstract
In the depths of the 2010 financial crisis the Portuguese government enacted a series of reforms in its prescription drug reimbursement system. Over the next three years value added per pharmacist in retail pharmacies fell by a third, reflecting a rise in generic substitution and reductions in the markups allowed for prescription drugs. This massive shock led to pay cuts for incumbent pharmacists and the introduction of a two-tier pay system for new hires, with little or no reduction in the growth of employment. We use detailed longitudinal records from the Quadros de Pessoal data base, merged with information on collective bargaining settlements and firm financial records, to study the impacts of the reforms. We estimate that between 2009 and 2022 average wages of pharmacists fell by a third; most of this reduction was due to lower wages for newly entering cohorts. The implied responsiveness of wages to productivity is substantially above most estimates in the rent-sharing literature, arguably reflecting the strong attachment of workers to the sector and the steady inflow of newly graduating pharmacists. Stepping back, we then consider how wages of pharmacists have diverged relative to wages of other health care professionals in Portugal, and the decisions of recent college applicants to enter the profession.