Working Paper: NBER ID: w17943
Authors: Jessica Cohen; Pascaline Dupas; Simone G. Schaner
Abstract: Both under- and over-treatment of communicable diseases are public bads. But efforts to decrease one run the risk of increasing the other. Using rich experimental data on household treatment-seeking behavior in Kenya, we study the implications of this tradeoff for subsidizing life-saving antimalarials sold over-the-counter at retail drug outlets. We show that a very high subsidy (such as the one under consideration by the international community) dramatically increases access, but nearly half of subsidized pills go to patients without malaria. We study two ways to better target subsidized drugs: reducing the subsidy level and introducing rapid malaria tests over-the-counter.
Keywords: malaria; subsidies; diagnostic tests; treatment targeting
JEL Codes: D61; H23; I18; O1
Edges that are evidenced by causal inference methods are in orange, and the rest are in light blue.
| Cause | Effect |
|---|---|
| 92% subsidy (H20) | access to ACTs (P46) |
| 80% subsidy (H23) | targeting of ACTs (F38) |
| subsidy level decrease (H23) | targeting improvement (L21) |
| subsidy decrease (H23) | mechanical drop in adult dose purchases (Y90) |
| subsidy decrease (H23) | reallocation of purchases towards higher probability malaria cases (F35) |
| introduction of RDTs (O32) | testing rate for malaria (C12) |
| negative test results (C52) | compliance with ACTs (H26) |