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知识处方:患者信息与仿制药替代

A prescription for knowledge: Patient information and generic substitution
Journal of Public Economics · 2026 · [{"name": "Linn Hjalmarsson", "affiliation": ["CSS (Switzerland)"]}, {"name": "Christian P.R. Schmid", "affiliation": ["CSS (Switzerland)"]}, {"name": "Nicolas Schreiner", "affiliation": ["University of Basel", "CSS (Switzerland)"]}]

中文摘要

本文考察信息摩擦与注意力不足在医疗保健市场中的作用。我们分析了直接向患者提供针对性信息对其在品牌药与仿制药之间选择的影响。基于一家瑞士健康保险公司寄出的60,000封信息信函的行政数据, 并利用信函寄送时间的准随机安排, 我们发现, 告知患者存在更便宜的替代品会使仿制药替代的可能性增加近四倍。至关重要的是, 这一效应在很大程度上并不取决于患者的共付状态。我们的研究结果凸显了: 当患者对自身选择缺乏充分信息时, 仅依赖经济激励的医疗保健政策存在局限。• 研究60,000封向品牌药购买者告知仿制药存在的定向信函。• 准随机的邮寄延迟识别了该信息的因果效应。• 相对于10%的基准水平, 信函使仿制药替代增加至四倍。• 即使没有经济激励, 患者信息也会对决策产生很大影响。

Abstract

This paper examines the role of information frictions and inattention in the market for health care. We analyze the impact of providing targeted information directly to patients on their choice between brand-name and generic drugs. Using administrative data on 60,000 informational letters sent by a Swiss health insurer, and exploiting the quasi-randomized timing of the dispatch, we find that informing patients of cheaper alternatives leads to an almost fourfold increase in the likelihood of generic substitution. Crucially, this effect does not substantially depend on the patient’s co-payment status. Our results highlight the limits of healthcare policies relying solely on financial incentives when patients lack sufficient information regarding their choices. • Study 60,000 targeted letters informing brand buyers about the existence of generics. • Quasi-random mailing delays identify the causal effect of this information. • Letters quadruple generic substitution relative to a 10% baseline. • Patient information has a large impact on decisions even without financial incentives.
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