I’m a third year PhD Candidate in Economics at the University of Bern. 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) 2022

Substituting brand-name drugs with generic alternatives constitutes a comparatively simple measure to reduce healthcare expenditures. Despite various policies and schemes aiming to increase substitution through financial incentives, the share of generics remains below full adoption. However, patients have to first know about the existence of less expensive alternatives for being able to switch. Yet given the crucial role of information, little empirical evidence exists as to how large of a factor the absence of knowledge is and sensitivity of substitution to information provision. We study a targeted mailing campaign by a health insurer in Switzerland and exploit quasi-random variation in the timing of the individual dispatch of these generics letters. By implementing a novel approach of using the position of a claim within a patient’s purchase history of a particular drug and whether a given claim was before or after the information treatment in an event study design, allows us to causally estimate the effect of specifically targeted information on generic substitution probability. Our results show that informing brand-name purchasers merely about the existence of generic alternatives leads to a fourfold increase in the uptake of generics. The findings highlight the potential for providing precisely targeted information directly to patients for healthcare policy.

Christmas Shopping in the Prescription Drug Market (with Michael Gerfin) 2023

Many modern health insurance contracts consist of a combination of deductibles, varying co-insurance rates and a stop-loss. While these features aim at solving the trade-off between risk protection and maintaining incentives, they also create nonlinear price-schedules. Using detailed individual level claims data from a large Swiss health insurer, we analyse the extent to which patients respond to the discrete increase in the spot price induced by the deductible reset at the beginning of each year. Especially, we focus on whether and to what extent chronically ill patients intertemporarily substitute prescription drug purchases. Employing a regression-discontinuity-design, we find that patients increase their chronic prescription drug purchases by around 50% on average at the end of a year, when they face a temporarily low marginal price. In contrast, we find only a minor and statistically insignificant effect for antibiotics. These findings show that at least some patients heavily react to the spot price. Thus, indicating that they don’t understand the entire complexity of the nonlinear contract as their expected end-of-year price hardly changes.

Conference Presentations

  • 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 (expected).
    • 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
  • Seminar Workshop in Econometrics I (Bachelor), Fall 2021 & 2022 & 2023