We assess the relative importance of demand and supply factors as determinants of regional variation in healthcare expenditures in the Netherlands. Our empirical approach follows individuals who migrate between regions. We use individual data on annual healthcare expenditures for the entire Dutch population between the years 2006 and 2013. Regional variation in healthcare expenditures is mostly driven by demand factors, with an estimated share of around 70%. Both demographics and other unobserved demand factors, e.g. patient preferences, are important components of the demand share. The relative importance of different causes varies with the groups of regions being compared.
Health Economics,2019

Working papers

We identify four key properties that characterize the outbreak of a new infectious disease in a globalized world: medical uncertainty, strategic uncertainty, strategic complementarity, and simultaneous policy responses. When jointly considered, these properties imply a global game. For a world consisting of N ≥ 2 countries, we prove uniqueness of equilibrium. This result relies crucially on the medical uncertainty, since games of complete information and strategic complementarities generically have multiple equilibria. We show that the unique equilibrium may be inefficient: countries may choose not to eradicate the disease when eradication would be efficient. Furthermore, an intrinsically more lethal disease might in equilibrium cause fewer deaths than a less lethal one. Only strong ex-ante cooperation can prevent a ‘rational pandemic’.

In the last two decades, many European countries allowed the sale of Over-the-Counter (OTC) drugs outside pharmacies. This was expected to lower retail prices through increased competition. However, evidence of price reductions is scarce. We assess the impact of supermarket and outlet entry in the OTC drug market on OTC prices charged by incumbent pharmacies, using a difference-in-differences strategy. We use price data on five popular OTC drugs for all retailers located in Lisbon for three distinct points in time (2006, 2010, and 2015). Our results suggest that competitive pressure in the market is mainly exerted by supermarkets, which charge, on average, 20% lower prices than pharmacies. The entry of a supermarket among the main competitors of an incumbent pharmacy is associated with an average 3 to 9% decrease in prices compared to the control group. These price reductions are long-lasting, but fairly localized. We find no evidence of price reductions following outlet entry. Additional results from a reduced-form entry model and a propensity score matching difference-in-differences approach suggest that these effects are causal.
Working paper,2019

Work in Progress

Recent & Upcoming Talks

16-18 October: 16th Portuguese Health Economics Conference. Lisbon, Portugal.

13-17 July: International Health Economics Association 2019 Congress. Basel, Switzerland.

3-4 July: American-European Health Economics Study Group - IV Edition. WU Vienna University of Economics and Business, Vienna, Austria.


I am an instructor for Data-Analysis (BSc course) and a teaching assistant for Statistics (Pre-MSc course) at Tilburg University.

In Fall 2014 I was a teaching assistant for Health Economics (MSc course) at the National School of Public Health, UNL, Portugal.