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In most developed countries drugs are dispensed to patients through physicians and pharmacists. This paper studies the eects of allowing doctors to directly dispense drugs to patients (self-dispensation) on pharmaceutical coverage. We use a Swiss dataset in our empirical analysis because Switzerland's federalist legislation allows us to study self-dispensing and non-self-dispensing regimes alike. We add location information obtained from Google Geocoding services to our dataset in order to measure coverage based on distances. To capture a driver of long term positioning decisions, we take revenues as a proxy for a pharmacy's usage rate. We nd that, ceteris paribus, self-dispensation leads to a lowered regional density of pharmacies. By matching similar pharmacies across both regimes we nd that revenues are substantially lower for pharmacies under a self-dispensation regime. Pharmacies in cantons that allow physicians to dispense drugs tend to have relatively higher revenues associated with non-drugs. We suggest to organize legislation on self-dispensation at a ne grained regional level as regional typologies are the most reasonable justication for regime choice.

Ask Your Doctor or Pharmacist! On the Effect of Self-Dispensing Physicians on Pharmaceutical Coverage