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Can Good Products Drive Out Bad? Evidence from Local Markets for (Fake?) Antimalarial Medicine in Uganda

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  • Svensson, Jakob
  • Björkman Nyqvist, Martina
  • Yanagizawa-Drott, David

Abstract

Counterfeit and sub-standard antimalarial drugs present a growing threat to public health. This paper investigates the mechanisms that determine the prevalence of fake antimalarial drugs in local markets, their effects, and potential interventions to combat the problem. We collect drug samples from a large set of local markets in Uganda using covert shoppers and employ Raman spectroscopy to test for drug quality. We find that 37 percent of the local outlets sell fake antimalarial drugs. Motivated by a simple model, we conduct a market-level experiment to test whether authentic drugs can drive out fake drugs from the local market. We find evidence of such externalities: the intervention reduced prevalence of substandard and counterfeit drugs in incumbent outlets by half. We also provide suggestive evidence that misconceptions about malaria lead consumers to overestimate antimalarial drug quality, and that opportunistic drug shops exploit these misconceptions by selling substandard and counterfeit drugs. Together, our results indicate that high quality products can drive out low quality ones, but the opposite is true when consumers are less able to infer product quality.

Suggested Citation

  • Svensson, Jakob & Björkman Nyqvist, Martina & Yanagizawa-Drott, David, 2012. "Can Good Products Drive Out Bad? Evidence from Local Markets for (Fake?) Antimalarial Medicine in Uganda," CEPR Discussion Papers 9114, C.E.P.R. Discussion Papers.
    • Handle: RePEc:cpr:ceprdp:9114
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    Cited by:

    1. Nicholas Wilson, 2015. "Can Disease-Specific Funding Harm Health? in the Shadow of HIV/AIDS Service Expansion," Demography, Springer;Population Association of America (PAA), vol. 52(5), pages 1671-1700, October.
    2. Daniel Bennett & Wesley Yin, 2014. "The Market for High-Quality Medicine," NBER Working Papers 20091, National Bureau of Economic Research, Inc.
    3. Tessa Bold & Jakob Svensson, 2013. "Policies and Institutions for Effective Service Delivery: The Need of a Microeconomic and Micropolitical Approach," Journal of African Economies, Centre for the Study of African Economies, vol. 22(suppl_2), pages -38, August.
    4. Jessica Cohen & Pascaline Dupas & Simone Schaner, 2015. "Price Subsidies, Diagnostic Tests, and Targeting of Malaria Treatment: Evidence from a Randomized Controlled Trial," American Economic Review, American Economic Association, vol. 105(2), pages 609-645, February.
    5. Adrienne M. Lucas & Nicholas L. Wilson, 2018. "Can At-Scale Drug Provision Improve the Health of the Targeted in Sub-Saharan Africa?," American Journal of Health Economics, MIT Press, vol. 4(3), pages 358-382, Summer.
    6. Esther Atukunda & Anne Fitzpatrick, 2015. "An Evaluation of Factors Affecting Drug Quality: Evidence from the Antimalarial Market in Uganda," Working Papers 2015_03, University of Massachusetts Boston, Economics Department.
    7. Schaefer, K. Aleks, 2016. "Anti-Malarial Biotechnology, Drug Resistance, and the Dynamics of Disease Management," 2016 Annual Meeting, July 31-August 2, Boston, Massachusetts 235716, Agricultural and Applied Economics Association.
    8. Pascaline Dupas & Edward Miguel, 2016. "Impacts and Determinants of Health Levels in Low-Income Countries," NBER Working Papers 22235, National Bureau of Economic Research, Inc.
    9. Ashour, Maha & Billings, Lucy & Gilligan, Daniel & Hoel, Jessica B. & Karachiwalla, Naureen, 2016. "Do beliefs about agricultural inputs counterfeiting correspond with actual rates of counterfeiting? Evidence from Uganda:," IFPRI discussion papers 1552, International Food Policy Research Institute (IFPRI).

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    More about this item

    Keywords

    Act; Asymmetric information; Counterfeit medicine; Field experiment; Malaria;
    All these keywords.

    JEL classification:

    • D83 - Microeconomics - - Information, Knowledge, and Uncertainty - - - Search; Learning; Information and Knowledge; Communication; Belief; Unawareness
    • I15 - Health, Education, and Welfare - - Health - - - Health and Economic Development
    • O12 - Economic Development, Innovation, Technological Change, and Growth - - Economic Development - - - Microeconomic Analyses of Economic Development

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