Dispensing practices and antibiotic use

Regulation of prescription and dispensing of antibiotics has a twin purpose: to enhance access to antibiotic treatment and to reduce inappropriate use of drugs. Nevertheless, incentives on antibiotics to dispensing physicians may lead to inefficiencies. We sketch a theoretical model of the market for antibiotic treatment and empirically investigate the impact of self-dispensing on antibiotic consumption by means of spatial econometric estimators. The investigation exploits data from small geographic areas in a country where both regimes - with and without dispensing physicians - are possible. We find evidence that dispensing practices increase antibiotic use after controlling for determinants of demand and access, and spatial effects. This suggests that health authorities have a margin to adjust economic incentives on dispensing practices in order to reduce antibiotic misuse.