Research incentives

The project explores the links between cooperation, conflict, identity, and illusions. How can valuable cooperation and prosocial behaviour be encouraged and sustained? How are different forms of anti-social behaviour best prevented or reduced? What role does identity play in cooperation and conflict? These questions are at the heart of many current debates: education, tax reform, immigration, health care, economic and cultural integration, climate change, population ageing…

To answer them, the project brings together economists, neuroeconomists and psychologists. The main scientific goal is twofold: first, to enhance our understanding of the cognitive and affective mechanisms driving cooperation, pro-social and anti-social behaviour, and conflict. Second, to study how social cooperation can be influenced by different institutions, such as different forms of reward and punishment,  different methods for aggregating individual preferences into collective decisions (e.g. voting rules), and different legal and regulatory frameworks.

The objective of this TSE funded project is to study from a microeconomic perspective, patient demand for health care and the supply of health care proposed by physicians. Because of lack of data in this field, which after all represents an important stake in terms of economic policy, not much research has been done on the following themes: physicians’ behavior concerning prescriptions, physician-patient interaction in demand for drugs, the effect of entry of generic drugs on prescription behavior, the entry of prescriptions and the appropriateness of the ASMR (Amélioration du Service Médical Rendu) used to determine the reimbursement rate in France. Thanks to the funding provided by TSE for this project, research in this field has become possible.

1 – Analysis of illnesses related to obesity
A first direction of research concerns patients affected by obesity. We use a sample of obese – defined as people who at some point in time had a body mass index higher than 30 – and overweight patients - defined as people who at some point in time had a body mass index higher than 25. We keep track of all their consultations and prescription with both general practitioners and specialists. We study the demand for health care related to chronic problems suffered by overweight people, for instance high blood pressure, cholesterol and diabetes. We can thus, by using econometric procedures, see if demand for these patients is affected by the prescriber by comparing the prescriptions for a sick person prescribed by different physicians and the prescriptions made by one physician to “similar” patients. We can also identify the “efficiency” distribution of physicians and observe the link between their prescription and the state of health of their patients. We try to identify the effect of “over-prescription” and see if this is linked to demand for health care coming from the patient or if it is the behavior of the physician.

2 – Demand for drugs: brand-name versus generic
The objective of the second direction of research, carried out with longitudinal data on prescriptions by the physicians, is to identify on the same market the substitution effects between on the one hand the brands of drugs and on the other hand between brand-name drugs and generic drugs. In particular we study the effect on the market of entry of a new drug or a generic drug. We study how demand varies between brands of drugs and between brand-name and generic drugs. This analysis can be conducted on specific markets like for instance statins and/or proton pump inhibitors for which there are relatively few molecules compared to other groups of drugs like antibiotics or psychoactive drugs. The fact that there are few products allows us to analyze the demand in a very detailed way and maybe to identify the cost of learning and the switching cost for generic drugs, to observe whether the prescribers switch to generic drugs more or less fast and this as a function of various parameters and the reimbursement rule for drugs which itself might have changed over time. The project is to develop a model for demand for health care where patient-physician interaction is explicitly modeled in order to better understand how this demand evolves as a function of medical and technical progress, available products, patient and physician preferences and learning.