Learning and focalization in an Argentinean program of distribution of medicines

The Remediar Program is an initiative centrally developed by the Argentinean Ministry of Health with financial assistance from the Inter.-American Development Bank. The goal of the Program is to provide free ambulatory pharmaceutical products to low income population groups at the health care posts level (CAPS). Driven by the major macroeconomic crisis occurred in Argentina at the beginning of 2002, the intention of the Program was to shift primary care from public hospitals to the CAPS, enhancing allocative efficiency and increasing coverage of drugs, which constitutes about fifty three per cent of the monthly expenses on health care at the lowest income quintile. The initiative was focused on the distribution of medicines that accounts for eighty per cent of the motives of consultation at the first level of care. The goal of the paper is to analyze the presence of a learning process in the way the Program focalizes and distributes pharmaceutical assistance. By using a dynamic game of incomplete information, a recursive model is developed in order to estimate the dynamic of the implementation, searching for information updates in the implementation of the Program. A panel data set based on monthly distribution of drugs by province and by CAPS between October 2002 and December 2003 is used, complemented with socio-economic information at departmental level, provided by the Ministry of Health and the Argentinean Bureau of Statistics, respectively. Results support the basic hypothesis, especially after May 2003, when convergence among CAPS towards a more equitable distribution of drugs becomes significant: relative poor areas with higher levels of Unmet Basic Needs increasingly receive more assistance from the Program, at the time that richer jurisdictions reduce their participation in the amount of medicines distributed.