Publications

How does retirement affect health care expenditures? Evidence from a change in the retirement age (Anikó Bíró, Péter Elek, 2018)

Health Economics, 27(5): 803-818. DOI: 10.1002/hec.3639 Using individual‐level administrative panel data from Hungary, we estimate causal effects of retirement on outpatient and inpatient care expenditures and pharmaceutical expenditures. Our identification strategy is based on an increase in the official early retirement age of women, using that the majority of women retire upon reaching that age. According to our descriptive results, people who are working before the early retirement age have substantially lower healthcare expenditures than nonworkers, but the expenditure gap declines after retirement. Our causal estimates from a two‐part (hurdle) model show that the shares of women with positive outpatient...

Smoking ban and health at birth: Evidence from Hungary (Tamás Hajdu, Gábor Hajdu, 2018)

Economics and Human Biology, 30, 37-47. https://doi.org/10.1016/j.ehb.2018.05.003 In 2012, smoking restrictions were extended to hospitality venues in Hungary. Women working in bars and restaurants were primarily affected by the intervention. In this research, we analyze the effect of this smoking ban on the outcomes of their pregnancies. Using individual live birth, fetal loss, and infant mortality registry data, we examine the probability of live birth, indicators of health at birth, and the probability of death in the first year of life. We apply a difference-in-differences framework and show that the smoking ban has improved health at birth. We observed birth...

Adaptation or recovery after health shocks? Evidence using subjective and objective health measures (Anikó Bíró, Petra Baji, 2018)

Health Economics, 27(5): 850-864. DOI: 10.1002/hec.3644 In this paper, we analyse the effect of an onset of a health shock on subjective survival probability and compare it with objective survival probability and self‐reported health measures. In particular, we are interested in whether expectations of people respond to health shocks and whether these follow the evolution of objective life expectations and self‐reported health measures over time. Using longitudinal data from the Health and Retirement Study, we estimate fixed effects models of adaptation for the objective and subjective survival probabilities and for some self‐reported health measures. The results show that after cancer...

Implication of external price referencing and parallel trade on pharmaceutical expenditure: indirect evidence from lower-income European countries (Péter Elek et al., 2017)

Elek, P., Takács, E., Merész, G., & Kaló, Z. Health Policy and Planning, 32(3), 349-358. External price referencing (EPR) is applied more and more frequently worldwide by payers to control pharmaceutical prices. Together with the parallel trade of pharmaceuticals, EPR may result in lower pharmaceutical prices in higher-income countries and higher prices in lower-income countries, which implies that pharmaceutical expenditure grows more rapidly in the latter than in the former group. Our objective was to assess this hypothesis. We used hierarchical linear models on country-level panel data to show that—after controlling for compounding factors such as GDP, the proportion of the...

Policy objective of generic medicines from the investment perspective: The case of clopidogrel (Péter Elek et al., 2017)

Elek, P., Harsányi, A., Zelei, T., Csetneki, K., & Kaló, Z. Health Policy, 121(5), 558-565. The objective of generic drug policies in most countries is defined from a disinvestment perspective: reduction in expenditures without compromising health outcomes. However, in countries with restricted access of patients to original patented drugs, the objective of generic drug policies can also be defined from an investment perspective: health gain by improved patient access without need for additional health budget. This study examines the investment aspect of generic medicines by analyzing clopidogrel utilization in European countries between 2004 and 2014 using multilevel panel data models. We...