Working Paper No. 949

Effects of Competition between Healthcare Providers on Prescription of Antibiotics

Published: January 7, 2013, revised November 2014Pages: 28Keywords: Healthcare; Competition; Competition reform; AntibioticsJEL-codes: C23; H30; I11; I18

Effects of Competition between Healthcare Providers on Prescription of Antibiotics Sara Fogelberg


The introduction of antibiotics as a medical treatment after World War II helped to dramatically increase life expectancy in the industrialized world. However, over-prescription of antibiotics during the last few decades has led to a sharp increase in multi-resistant bacteria, disarming once powerful anti-pathogens. This paper investigates the effects of increased competition between healthcare providers on prescription of antibiotics. The analysis makes use of a competition-inducing reform implemented in different counties in Sweden at different points in time between 2007 and 2010 for a difference-in-differences approach. Since the dataset contains monthly data on all prescribed antibiotics in Sweden it is possible to estimate the effects on all antibiotics prescribed, as well as on different subcategories of antibiotics. The results show that increased competition had a positive and significant effect on prescription of antibiotics. This increase in prescription of antibiotics was not associated with a reduction in sick leave.

Interdisciplinary European Studies

The European Union in a Changing World Order

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This book explores how the European Union responds to the ongoing challenges to the liberal international order. These challenges arise both within the EU itself and beyond its borders, and put into question the values of free trade and liberal democracy. 

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