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Pharmacy Regulation in Sweden. A New Institutional Economic Perspective

Öberg, Klas LU (2003) In Lund Studies in Economic History 23.
Abstract (Swedish)
Popular Abstract in Swedish

Syftet med denna avhandling är att analysera och förklara den institutionella förändringen vad gäller läkemedelsförsäljning i Sverige. Avhandlingens bidrag är studier av denna specifika institutionella utveckling där nyinstitutionell ekonomisk teori har använts för att undersöka drivkrafterna. Avhandlingen består av tre artiklar. Syftet med den första artikeln är att beskriva och förklara bildandet av det regelverk som i huvudsak skapades under 1600-talet. De centrala frågorna i studien är hur detta regelverk var konstruerat och vilka faktorer som påverkade utformningen. Slutsatsen är att regelverket var skapat genom olika arrangemang som skapandet av; en hierarki inom hälso- och... (More)
Popular Abstract in Swedish

Syftet med denna avhandling är att analysera och förklara den institutionella förändringen vad gäller läkemedelsförsäljning i Sverige. Avhandlingens bidrag är studier av denna specifika institutionella utveckling där nyinstitutionell ekonomisk teori har använts för att undersöka drivkrafterna. Avhandlingen består av tre artiklar. Syftet med den första artikeln är att beskriva och förklara bildandet av det regelverk som i huvudsak skapades under 1600-talet. De centrala frågorna i studien är hur detta regelverk var konstruerat och vilka faktorer som påverkade utformningen. Slutsatsen är att regelverket var skapat genom olika arrangemang som skapandet av; en hierarki inom hälso- och sjukvårdsorganisationen, en farmacopeia, utbildning och inspektioner. Detta regelverk skapades i en process som går att likna vid ett kontrakt mellan olika intressenter som i huvudsak påverkades av tre faktorer; intressenternas förhandlingsstyrka, influenser från det område som idag är Tyskland och skråväsendet. Den andra artikeln beskriver och analyserar den organisatoriska förändring som genomfördes under de första decennierna under 1900-talet. Fokus i denna studie är idéerna bakom processen snarare än processen i sig. Tre faktorer hade störst påverkan i denna förändring, nationellt enhetliga priser på läkemedel, en nationell spridning av apoteksinrättningar samt opinionens låga acceptans vad gäller alltför stor vinstspridning bland apotekare. Skapandet av en intern vinstfond var en lösning med dessa förutsättningar. I den tredje artikeln jämförs utvecklingen i Sverige och Danmark vad gäller antal apoteksinrättningar och läkemedelspriser i syfte att klargöra betydelsen av olika regelverk. Ländernas regelverks skilde sig i huvudsak genom vinstutjämningen i Sverige. Antalet apotek ökade relativt sätt mer i Sverige, speciellt efter andra världskriget. Detta kan delvis förklaras med skillnader i ersättningssystem och geografiska skillnader, men även med skillnader i regelverket och då speciellt efter 1970. Läkemedel blev relativt sett dyrare i Danmark under 1900-talet. Utvecklingen av läkemedelspriser är dock en mycket komplex fråga och det har varit svårt att isolera betydelsen av skillnader i regelverk. (Less)
Abstract
The aim of this thesis is to analyze and to explain the institutional change in the provision of pharmaceuticals in Sweden. The thesis’ contribution is studies of this specific institutional development. New Institutional Economic theory is used to scrutinize the driving forces of this development. The thesis consist of three papers. The purpose of the first paper is to discuss and to analyze the historical roots of the set of rules and regulations, a development which mainly took place during the 17th century. Central issues are: how these regulations were carried out and what factors had an influence on how these regulations were designed. The conclusion of the analysis is that the regulations were carried out through arrangements, such... (More)
The aim of this thesis is to analyze and to explain the institutional change in the provision of pharmaceuticals in Sweden. The thesis’ contribution is studies of this specific institutional development. New Institutional Economic theory is used to scrutinize the driving forces of this development. The thesis consist of three papers. The purpose of the first paper is to discuss and to analyze the historical roots of the set of rules and regulations, a development which mainly took place during the 17th century. Central issues are: how these regulations were carried out and what factors had an influence on how these regulations were designed. The conclusion of the analysis is that the regulations were carried out through arrangements, such as the creation of a hierarchy within the health organization, a pharmacopeia, education and inspections. The set of regulation studied is regarded as a creation of a contracting process between parties and was mainly influenced by three factors, the bargaining power of the contracting parties, influences from the area that today is Germany and the guild system. The objective of the second paper is to describe and analyze the change in organization of pharmacies in Sweden that took place during the first decades of the 20th century. The principal question in this paper is why a process of collectivization occurred during the first decades of the 20th century. The focus of this study is on the ideas behind the process rather than the process itself. Three major factors had a significant impact on the institutional change; centralized and uniform prices, the demand for public access to pharmacies as well as a low public acceptance to wide profit range. A solution, with these prerequisites, was the creation of an internal profit fund. The third study compares Sweden and Denmark, and focuses the role played by the choice of regulatory system in the 1900s in terms of the number of pharmacies and prices of pharmaceuticals. The main difference between Swedish and Danish regulatory systems was the Swedish goal of equalisation of pharmacists’ incomes. The number of pharmacies expanded more in Sweden compared to Denmark, especially during the period after World War II. This could partly be explained by differences in the benefit system and geographical factors, but also by differences in the regulatory system, especially in the period after 1970. Pharmaceutical prices became more expensive in Denmark relative to Sweden during the studied period. The development of pharmaceutical prices is, however, a very complex issue, making it difficult to isolate the impact of a regulatory system. (Less)
Please use this url to cite or link to this publication:
author
supervisor
opponent
  • Univ. lektor Andersson-Skoog, Lena, Umeå universitet
organization
publishing date
type
Thesis
publication status
published
subject
keywords
Ekonomisk och social historia, Social and economic history, Denmark, Sweden, New Institutional Economics, Pharmacy, Regulation
in
Lund Studies in Economic History
volume
23
pages
164 pages
publisher
Almqvist & Wiksell International
defense location
Crafoordssalen, Holger Crafoords Ekonomicentrum, Lund
defense date
2003-04-26 10:15
ISSN
1400-4860
ISBN
91-22-02005-5
language
English
LU publication?
yes
id
0a51552a-2637-4cd2-99fa-1184a31ba94f (old id 465759)
date added to LUP
2007-09-27 11:46:11
date last changed
2018-05-29 11:43:15
@phdthesis{0a51552a-2637-4cd2-99fa-1184a31ba94f,
  abstract     = {The aim of this thesis is to analyze and to explain the institutional change in the provision of pharmaceuticals in Sweden. The thesis’ contribution is studies of this specific institutional development. New Institutional Economic theory is used to scrutinize the driving forces of this development. The thesis consist of three papers. The purpose of the first paper is to discuss and to analyze the historical roots of the set of rules and regulations, a development which mainly took place during the 17th century. Central issues are: how these regulations were carried out and what factors had an influence on how these regulations were designed. The conclusion of the analysis is that the regulations were carried out through arrangements, such as the creation of a hierarchy within the health organization, a pharmacopeia, education and inspections. The set of regulation studied is regarded as a creation of a contracting process between parties and was mainly influenced by three factors, the bargaining power of the contracting parties, influences from the area that today is Germany and the guild system. The objective of the second paper is to describe and analyze the change in organization of pharmacies in Sweden that took place during the first decades of the 20th century. The principal question in this paper is why a process of collectivization occurred during the first decades of the 20th century. The focus of this study is on the ideas behind the process rather than the process itself. Three major factors had a significant impact on the institutional change; centralized and uniform prices, the demand for public access to pharmacies as well as a low public acceptance to wide profit range. A solution, with these prerequisites, was the creation of an internal profit fund. The third study compares Sweden and Denmark, and focuses the role played by the choice of regulatory system in the 1900s in terms of the number of pharmacies and prices of pharmaceuticals. The main difference between Swedish and Danish regulatory systems was the Swedish goal of equalisation of pharmacists’ incomes. The number of pharmacies expanded more in Sweden compared to Denmark, especially during the period after World War II. This could partly be explained by differences in the benefit system and geographical factors, but also by differences in the regulatory system, especially in the period after 1970. Pharmaceutical prices became more expensive in Denmark relative to Sweden during the studied period. The development of pharmaceutical prices is, however, a very complex issue, making it difficult to isolate the impact of a regulatory system.},
  author       = {Öberg, Klas},
  isbn         = {91-22-02005-5},
  issn         = {1400-4860},
  keyword      = {Ekonomisk och social historia,Social and economic history,Denmark,Sweden,New Institutional Economics,Pharmacy,Regulation},
  language     = {eng},
  pages        = {164},
  publisher    = {Almqvist & Wiksell International},
  school       = {Lund University},
  series       = {Lund Studies in Economic History},
  title        = {Pharmacy Regulation in Sweden. A New Institutional Economic Perspective},
  volume       = {23},
  year         = {2003},
}