Hi, thanks for dropping by. I recently finished my PhD in Economics at the University of Bern and I am currently working as a researcher at the CSS Institute for Empirical Health Economics. My main research interests are in the field of Applied Public Economics, especially empirical Health Economics.

Publications

The impact of physician exits in primary care: A study of practice handovers with Boris Kaiser and Tamara Bischof (Health Policy, 2023, Vol 135)

Recent studies on physician exits suggest that general practitioners (GPs) have an important impact on health care utilization and costs, but the transmission channels - interpersonal dis- continuities of care, practice style differences and deterioration in access - are usually not clear. Our objective is to estimate the short-run and long-run impacts of switches in GPs on patients’ health care utilization and costs, while all other factors of the health care setting remain the same. To do this, we collect data on handovers of primary care practices in Switzerland, occurring between 2007 and 2015. We link this data to rich insurance claims to construct a panel dataset of roughly 240,000 patients. Employing a difference-in-difference type framework, we find transitory increases in overall visits and costs, which are likely caused by the entering GP’s initial re-assessment of patients’ health care needs. Additionally, we find long-term increases in specialist health care utilization and ambulatory costs. The latter finding can be explained by changes in practice styles between the exiting GP and her successor, who is typically much younger and more likely to be female. In contrast to the literature on practice closures, we do not find evidence on reduced overall utilization rates. An important lesson for health policy is thus to preserve patients’ access to care in the case of GP exits.

Work in Progress

A Prescription for Knowledge: Patient Information and Generic Substitution (with Nicolas Schreiner and Christian Schmid)

Markets require informed participants to function efficiently. This paper examines the impact of providing targeted information directly to patients on their purchasing-decisions regarding pharmaceutical drugs. We analyze the effect of informational letters sent by a Swiss health insurer to clients who had recently purchased a brand-name drug, informing them of available generic alternatives and potential savings. Utilizing the quasi-randomized timing of the letter dispatch, we employ an event study design with staggered treatment adoption to estimate the causal effect of patient information on generic substitution probability. Based on 540,000 drug purchases by 60,000 patients we find that the probability of switching to a generic alternative increases by almost 30 percentage points immediately after receiving the informational letter, representing nearly a fourfold rise in the substitution likelihood among previous brand-name drug buyers. Furthermore, the effect does not substantially depend on whether patients face a copayment for their drug purchase and thus personally financially benefit from switching. Our results highlight the limits of healthcare policies that rely solely on financial incentives, particularly if patients lack sufficient information in their decision-making.

Christmas Shopping in the Prescription Drug Market (with Michael Gerfin)

Health insurance contracts typically include a combination of various cost-sharing features. These are designed to balance the trade-off between risk protection and maintaining incentives, but they also generate nonlinear price schedules and dynamic incentives. In this study, we analyse whether individuals react rationally to these incentives. To do so, we utilize extensive individual-level claims data obtained from a large Swiss health insurer linked to detailed pharmaceutical information. We focus on patients with chronic conditions. They experience a very salient increase of the spot price caused by the deductible reset at the start of a year, but their expected end-of-year price, the price they should react to, is unaffected by the deductible reset. Employing a regression discontinuity design, our analysis reveals that the difference between the amount of DDDs purchased in December compared to January corresponds to around 50% of the yearly average DDDs purchased. This is at least partially caused by individuals who purchase in December to avoid the high spot price early in the following year. In other words, a fraction of consumers is highly responsive to spot prices, indicating a limited understanding of the complexity of their health insurance contract. This is further evidence for apparent irrational behavior induced by deductibles.

Presentations

• 2024
  • Biannual Conference of the European Health Economics Association (EUHEA), Vienna University of Economics and Business
• 2023
  • Research Seminar in Health Sciences, Faculty of Health Sciences and Medicine, University of Lucerne
  • Applied Micro Seminar, Department of Economics, University of Gothenburg
  • sggö PhD Conference, University of Bern
  • Brown Bag, Department of Economics, University of Bern
  • dggö Annual Conference, Leibniz University Hannover
• 2022
  • Brown Bag, Department of Economics, University of Bern
  • Swiss Health Economics Workshop, Lucerne
  • Biannual Conference of the European Health Economics Association (EUHEA), University of Oslo

CV

Personal

• Swiss and Swedish Citizen.

Research Interests

Health Economics, Applied Microeconometrics, Applied Public Economics

Education

• Ph.D. in Economics, University of Bern, 2021-2024.
  • Swiss Program for Beginning Doctoral Students in Economics (Microeconomics, Econometrics), Study Center Gerzensee, 2020-2021.
• M.Sc. in Applied Economic Analysis, University of Bern, 2018-2020.
• B.Sc. in Economics, University of Bern, 2015-2018.

Teaching Assistant

• Introductory Econometrics (Bachelor), Spring 2021 & 2022 & 2023 & 2024
• Seminar Workshop in Econometrics I (Bachelor), Fall 2021 & 2022 & 2023