Browsing by Author "Carrera, Mariana"

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Generic Aversion and Observational Learning in the Over-the-Counter Drug Market
(American Economic Association, 2023-07) Carrera, Mariana; Villas-Boas, Sofia
Through a labeling intervention at a national retailer, we test three hypotheses for consumer aversion to generic over-the-counter drugs: lack of information on the comparability of generic and brand drugs, inattention to their price differences, and uncertainty about generic quality that can be reduced with information on peer purchase rates. With a difference-in-differences strategy, we find that posted information on the purchases of other customers increases generic purchase shares significantly, while other treatments have mixed results. Consumers without prior generic purchases appear particularly responsive to this information. These findings have policy implications for promoting evidence-based, cost-effective choices.
Population Mortality and Laws Encouraging Influenza Vaccination for Hospital Workers
(American College of Physicians, 2021-04) Carrera, Mariana; Lawler, Emily C.; White, Corey
Background: Since 1995, 14 states have passed laws encouraging or mandating influenza vaccination for hospital workers. Although the Centers for Disease Control and Prevention recommends vaccinating health care workers to reduce disease transmission and patient risk, the effect of these laws on pneumonia and influenza mortality is unknown. Objective: To measure the effect of state-level hospital worker influenza vaccination laws on pneumonia and influenza mortality. Design: Quasi-experimental observational study. Setting: United States. Participants: Population of all states from 1995 to 2017. Intervention: State adoption of a law promoting influenza vaccination for hospital workers. Measurements: Pneumonia and influenza mortality per 100 000 persons by state and by month, both population-wide and separately by age group, obtained from restricted-access National Vital Statistics System files. Linear and log-linear models were used to compare changes in mortality rates for adopting versus nonadopting states. Results: Implementation of state laws requiring hospitals to offer influenza vaccination to their employees was associated with a 2.5% reduction in the monthly pneumonia and influenza mortality rate (−0.16 deaths per 100 000 persons [95% CI, −0.29 to −0.02]; P = 0.022) during the years when the vaccine was well matched to the circulating strains. The largest effects occurred among elderly persons and during peak influenza months. Limitation: Utilization of large-scale national data precluded analysis of more specific outcomes, such as laboratory-confirmed or hospital-acquired influenza. Conclusion: State laws promoting hospital worker vaccination against influenza may be effective in preventing pneumonia- and influenza-related deaths, particularly among elderly persons. Vaccinating hospital workers may substantially reduce the spread of influenza and protect the most vulnerable populations.
Who Chooses Commitment? Evidence and Welfare Implications
(Oxford University Press, 2021-09) Carrera, Mariana; Royer, Heather; Stehr, Mark; Sydnor, Justin; Taubinsky, Dmitry
This paper investigates whether offers of commitment contracts, in the form of self-imposed choice-set restrictions and penalties with no financial upside, are well-targeted tools for addressing self-control problems. In an experiment on gym attendance (N = 1,248), we examine take-up of commitment contracts, and also introduce a separate elicitation task to identify actual and perceived time inconsistency. There is high take-up of commitment contracts for greater gym attendance, resulting in significant increases in exercise. However, this is take-up is influenced both by noisy valuation and incorrect beliefs about one’s time inconsistency. Approximately half of the people who take up commitment contracts for higher gym attendance also take up commitment contracts for lower gym attendance. There is little association between commitment contract take-up and reduced-form and structural estimates of actual or perceived time inconsistency. A novel information treatment providing an exogenous shock to awareness of time inconsistency reduces demand for commitment contracts. Structural estimates of a model of quasi-hyperbolic discounting and gym attendance imply that offering our commitment contracts lowers consumer surplus, and is less socially efficient than utilizing linear exercise subsidies that achieve the same average change in behavior.