IDEAS home Printed from https://ideas.repec.org/a/eee/jhecon/v92y2023ics0167629623000966.html
   My bibliography  Save this article

Consequences of a shortage and rationing: Evidence from a pediatric vaccine

Author

Listed:
  • Liebman, Eli
  • Lawler, Emily C.
  • Dunn, Abe
  • Ridley, David B.

Abstract

Shortages and rationing are common in health care, yet we know little about the consequences. We examine an 18-month shortage of the pediatric Haemophilus Influenzae Type B (Hib) vaccine. Using insurance claims data and variation in shortage exposure across birth cohorts, we find that the shortage reduced uptake of high-value primary doses by 4 percentage points and low-value booster doses by 26 percentage points. This suggests providers largely complied with rationing recommendations. In the long-run, catch-up vaccination occurred but was incomplete: shortage-exposed cohorts were 4 percentage points less likely to have received the ir booster dose years later. We also find that the shortage and rationing caused provider switches, extra provider visits, and negative spillovers to other care.

Suggested Citation

  • Liebman, Eli & Lawler, Emily C. & Dunn, Abe & Ridley, David B., 2023. "Consequences of a shortage and rationing: Evidence from a pediatric vaccine," Journal of Health Economics, Elsevier, vol. 92(C).
  • Handle: RePEc:eee:jhecon:v:92:y:2023:i:c:s0167629623000966
    DOI: 10.1016/j.jhealeco.2023.102819
    as

    Download full text from publisher

    File URL: http://www.sciencedirect.com/science/article/pii/S0167629623000966
    Download Restriction: Full text for ScienceDirect subscribers only

    File URL: https://libkey.io/10.1016/j.jhealeco.2023.102819?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    As the access to this document is restricted, you may want to look for a different version below or search for a different version of it.

    Other versions of this item:

    References listed on IDEAS

    as
    1. Agha, Leila & Frandsen, Brigham & Rebitzer, James B., 2019. "Fragmented division of labor and healthcare costs: Evidence from moves across regions," Journal of Public Economics, Elsevier, vol. 169(C), pages 144-159.
    2. Corey White, 2021. "Measuring Social and Externality Benefits of Influenza Vaccination," Journal of Human Resources, University of Wisconsin Press, vol. 56(3), pages 749-785.
    3. Andersson, Ola & Campos-Mercade, Pol & Meier, Armando N. & Wengström, Erik, 2021. "Anticipation of COVID-19 vaccines reduces willingness to socially distance," Journal of Health Economics, Elsevier, vol. 80(C).
    4. Leila Agha & Keith Marzilli Ericson & Xiaoxi Zhao, 2023. "The Impact of Organizational Boundaries on Health Care Coordination and Utilization," American Economic Journal: Economic Policy, American Economic Association, vol. 15(3), pages 184-214, August.
    5. A. Colin Cameron & Jonah B. Gelbach & Douglas L. Miller, 2008. "Bootstrap-Based Improvements for Inference with Clustered Errors," The Review of Economics and Statistics, MIT Press, vol. 90(3), pages 414-427, August.
    6. Kim, Dongwoo & Lee, Young Jun, 2022. "Vaccination strategies and transmission of COVID-19: Evidence across advanced countries," Journal of Health Economics, Elsevier, vol. 82(C).
    7. Schaller, Jessamyn & Schulkind, Lisa & Shapiro, Teny, 2019. "Disease outbreaks, healthcare utilization, and on-time immunization in the first year of life," Journal of Health Economics, Elsevier, vol. 67(C).
    8. W. Erwin Diewert & Kevin J. Fox, 2022. "Measuring real consumption and consumer price index bias under lockdown conditions," Canadian Journal of Economics/Revue canadienne d'économique, John Wiley & Sons, vol. 55(S1), pages 480-502, February.
    9. Oster, Emily, 2018. "Does disease cause vaccination? Disease outbreaks and vaccination response," Journal of Health Economics, Elsevier, vol. 57(C), pages 90-101.
    10. Churchill, Brandyn F., 2021. "How important is the structure of school vaccine requirement opt-out provisions? Evidence from Washington, DC's HPV vaccine requirement," Journal of Health Economics, Elsevier, vol. 78(C).
    11. Ali Yurukoglu & Eli Liebman & David B. Ridley, 2017. "The Role of Government Reimbursement in Drug Shortages," American Economic Journal: Economic Policy, American Economic Association, vol. 9(2), pages 348-382, May.
    12. de Janvry, Alain & Sadoulet, Elisabeth & Villas-Boas, Sofia, 2010. "Short on shots: Are calls for cooperative restraint effective in managing a flu vaccines shortage?," Journal of Economic Behavior & Organization, Elsevier, vol. 76(2), pages 209-224, November.
    13. Lenisa V. Chang, 2018. "Information, education, and health behaviors: Evidence from the MMR vaccine autism controversy," Health Economics, John Wiley & Sons, Ltd., vol. 27(7), pages 1043-1062, July.
    14. Abe Dunn & Eli Liebman & Adam Hale Shapiro, 2014. "Developing a Framework for Decomposing Medical-Care Expenditure Growth: Exploring Issues of Representativeness," NBER Chapters, in: Measuring Economic Sustainability and Progress, pages 545-574, National Bureau of Economic Research, Inc.
    15. Lawler, Emily C., 2017. "Effectiveness of vaccination recommendations versus mandates: Evidence from the hepatitis A vaccine," Journal of Health Economics, Elsevier, vol. 52(C), pages 45-62.
    16. Rachel Soloveichik, 2022. "Theoretical Inflation for Unavailable Products," BEA Working Papers 0193, Bureau of Economic Analysis.
    17. Christopher S. Carpenter & Emily C. Lawler, 2019. "Direct and Spillover Effects of Middle School Vaccination Requirements," American Economic Journal: Economic Policy, American Economic Association, vol. 11(1), pages 95-125, February.
    18. Thomas C. Buchmueller & Colleen Carey, 2018. "The Effect of Prescription Drug Monitoring Programs on Opioid Utilization in Medicare," American Economic Journal: Economic Policy, American Economic Association, vol. 10(1), pages 77-112, February.
    19. Mattan Alalouf & Sarah Miller & Laura R. Wherry, 2019. "What Difference Does a Diagnosis Make? Evidence from Marginal Patients," NBER Working Papers 26363, National Bureau of Economic Research, Inc.
    20. Lenisa V. Chang, 2016. "The Effect Of State Insurance Mandates On Infant Immunization Rates," Health Economics, John Wiley & Sons, Ltd., vol. 25(3), pages 372-386, March.
    21. Fitzpatrick, Anne, 2022. "The impact of public health sector stockouts on private sector prices and access to healthcare: Evidence from the anti-malarial drug market," Journal of Health Economics, Elsevier, vol. 81(C).
    Full references (including those not matched with items on IDEAS)

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Alexander Karaivanov & Dongwoo Kim & Shih En Lu & Hitoshi Shigeoka, 2022. "COVID-19 vaccination mandates and vaccine uptake," Nature Human Behaviour, Nature, vol. 6(12), pages 1615-1624, December.
    2. Garrouste, Clémentine & Juet, Arthur & Samson, Anne-Laure, 2023. "Direct and crowding-out effects of a Hepatitis B vaccination campaign," Economics & Human Biology, Elsevier, vol. 51(C).
    3. Hoffmann, Manuel & Mosquera, Roberto & Chadi, Adrian, 2019. "Vaccines at Work," VfS Annual Conference 2019 (Leipzig): 30 Years after the Fall of the Berlin Wall - Democracy and Market Economy 203661, Verein für Socialpolitik / German Economic Association.
    4. Humlum, Maria Knoth & Morthorst, Marius Opstrup & Thingholm, Peter Rønø, 2024. "Sibling spillovers and the choice to get vaccinated: Evidence from a regression discontinuity design," Journal of Health Economics, Elsevier, vol. 94(C).
    5. Hair, Nicole L. & Gruber, Anja & Urban, Carly, 2021. "Personal belief exemptions for school-entry vaccinations, vaccination rates, and academic achievement," Journal of Health Economics, Elsevier, vol. 78(C).
    6. Giulietti, Corrado & Vlassopoulos, Michael & Zenou, Yves, 2021. "When Reality Bites: Local Deaths and Vaccine Take-Up," GLO Discussion Paper Series 999, Global Labor Organization (GLO).
    7. Giulietti, Corrado & Vlassopoulos, Michael & Zenou, Yves, 2023. "When reality bites: Local deaths and vaccine take-up," European Economic Review, Elsevier, vol. 156(C).
    8. Brilli, Ylenia & Lucifora, Claudio & Russo, Antonio & Tonello, Marco, 2020. "Vaccination take-up and health: Evidence from a flu vaccination program for the elderly," Journal of Economic Behavior & Organization, Elsevier, vol. 179(C), pages 323-341.
    9. Carpenter, Christopher S. & Churchill, Brandyn F. & Marcus, Michelle, 2023. "Bad lighting: Effects of youth indoor tanning prohibitions," Journal of Health Economics, Elsevier, vol. 88(C).
    10. Schaller, Jessamyn & Schulkind, Lisa & Shapiro, Teny, 2019. "Disease outbreaks, healthcare utilization, and on-time immunization in the first year of life," Journal of Health Economics, Elsevier, vol. 67(C).
    11. Seth M. Freedman & Daniel W. Sacks & Kosali I. Simon & Coady Wing, 2022. "Direct and indirect effects of vaccines: Evidence from COVID-19," NBER Working Papers 30550, National Bureau of Economic Research, Inc.
    12. Hirani, Jonas Cuzulan & Wüst, Miriam, 2024. "Reminder design and childhood vaccination coverage," Journal of Health Economics, Elsevier, vol. 93(C).
    13. Stefan Pichler & Katherine Wen & Nicolas R. Ziebarth, 2021. "Positive Health Externalities of Mandating Paid Sick Leave," Journal of Policy Analysis and Management, John Wiley & Sons, Ltd., vol. 40(3), pages 715-743, June.
    14. Corey White, 2021. "Measuring Social and Externality Benefits of Influenza Vaccination," Journal of Human Resources, University of Wisconsin Press, vol. 56(3), pages 749-785.
    15. Shooshan Danagoulian & Daniel Grossman & David Slusky, 2022. "Health Care Following Environmental Disasters: Evidence from Flint," Journal of Policy Analysis and Management, John Wiley & Sons, Ltd., vol. 41(4), pages 1060-1089, September.
    16. Ericson, Keith Marzilli & Sacarny, Adam & Zhou, Annetta, 2023. "Dangerous prescribing and healthcare fragmentation: Evidence from opioids," Journal of Public Economics, Elsevier, vol. 225(C).
    17. Hair, Nicole L. & Gruber, Anja & Urban, Carly, 2020. "Personal Belief Exemptions for School-Entry Vaccinations, Vaccination Rates, and Academic Achievement," IZA Discussion Papers 12978, Institute of Labor Economics (IZA).
    18. Persson, Petra & Qiu, Xinyao & Rossin-Slater, Maya, 2021. "Family Spillover Effects of Marginal Diagnoses: The Case of ADHD," IZA Discussion Papers 14020, Institute of Labor Economics (IZA).
    19. Emanuele Amodio & Michele Battisti & Antonio Francesco Gravina & Andrea Mario Lavezzi & Giuseppe Maggio, 2023. "School‐age vaccination, school openings and Covid‐19 diffusion," Health Economics, John Wiley & Sons, Ltd., vol. 32(5), pages 1084-1100, May.
    20. Sansone, Dario, 2019. "Pink work: Same-sex marriage, employment and discrimination," Journal of Public Economics, Elsevier, vol. 180(C).

    More about this item

    Keywords

    Rationing; Shortage; Vaccine; Haemophilus Influenzae Type B;
    All these keywords.

    JEL classification:

    • I12 - Health, Education, and Welfare - - Health - - - Health Behavior
    • I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health
    • L65 - Industrial Organization - - Industry Studies: Manufacturing - - - Chemicals; Rubber; Drugs; Biotechnology; Plastics

    Statistics

    Access and download statistics

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:eee:jhecon:v:92:y:2023:i:c:s0167629623000966. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: Catherine Liu (email available below). General contact details of provider: http://www.elsevier.com/locate/inca/505560 .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.