{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,3]],"date-time":"2026-11-03T15:36:10Z","timestamp":1793720170627,"version":"4.6.1"},"reference-count":47,"publisher":"Springer Science and Business Media LLC","issue":"2","license":[{"start":{"date-parts":[[2025,9,2]],"date-time":"2025-09-02T00:00:00Z","timestamp":1756771200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2025,9,2]],"date-time":"2025-09-02T00:00:00Z","timestamp":1756771200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"Alma Mater Studiorum - Universit\u00e0 di Bologna"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Eur J Health Econ"],"published-print":{"date-parts":[[2026,3]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>This paper investigates the effects of regulations aiming to optimise the multi-agency relationships, with a focus on the prescription choice between generic versus branded medications. In 2012, Italian legislators introduced two laws targeting general practitioners prescription behaviour, a soft (recommendations) law followed by a hard (mandatory) law to promote generic medication. We implement a regression discontinuity in time framework and an event study to quarterly administrative data for individuals with chronic kidney disease linked to data from their general practitioners in Emilia-Romagna, Italy. The results indicate that the policies were effective, but had modest effects on increasing the prescription of generic medications. Hard laws seem to have played a key role in driving this change. Heterogeneity checks provide evidence that less competition among GPs and interaction with specialists increased generic medication prescriptions.<\/jats:p>","DOI":"10.1007\/s10198-025-01826-y","type":"journal-article","created":{"date-parts":[[2025,9,2]],"date-time":"2025-09-02T04:26:14Z","timestamp":1756787174000},"page":"453-477","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Tough versus soft regulations to promote generic medications in Italy"],"prefix":"10.1007","volume":"27","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3719-4414","authenticated-orcid":false,"given":"Aarushi","family":"Dhingra","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gianluca","family":"Fiorentini","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ayman","family":"Fouda","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Naomi","family":"Moy","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,9,2]]},"reference":[{"key":"1826_CR1","unstructured":"Altroconsumo: Branded drugs over generics. (2020). https:\/\/choosingwiselyitaly.org\/wp-content\/uploads\/2020\/03\/Unwarranted-distrust-of-generic-drugs.pdf"},{"issue":"2\u20133","key":"1826_CR2","doi-asserted-by":"publisher","first-page":"376","DOI":"10.1016\/j.healthpol.2006.07.005","volume":"81","author":"K Andersson","year":"2007","unstructured":"Andersson, K., Bergstr\u00f6m, G., Petzold, M.G., Carlsten, A.: Impact of a generic substitution reform on patients\u2019 and society\u2019s expenditure for pharmaceuticals. Health Policy 81(2\u20133), 376\u2013384 (2007)","journal-title":"Health Policy"},{"issue":"9","key":"1826_CR3","doi-asserted-by":"publisher","first-page":"4579","DOI":"10.3390\/ijerph18094579","volume":"18","author":"R Arcaro","year":"2021","unstructured":"Arcaro, R., da Veiga, C.R.P., da Silva, W.V., Pereira da Veiga, C.: Attitude and purchase intention to generic drugs. Int. J. Environ. Res. Public Health 18(9), 4579 (2021)","journal-title":"Int. J. Environ. Res. Public Health"},{"key":"1826_CR4","unstructured":"Belloni, A., Morgan, D., Paris, V.: Pharmaceutical expenditure and policies: Past trends and future challenges. OECD Health Working Papers (2016)"},{"issue":"6","key":"1826_CR5","doi-asserted-by":"publisher","first-page":"543","DOI":"10.1016\/j.autrev.2015.01.016","volume":"14","author":"M Biggioggero","year":"2015","unstructured":"Biggioggero, M., Danova, M., Genovese, U., Locatelli, F., Meroni, P.L., Pane, F., Scaglione, F.: The challenging definition of na\u00efve patient for biological drug use. Autoimmun. Rev. 14(6), 543\u2013546 (2015)","journal-title":"Autoimmun. Rev."},{"issue":"4","key":"1826_CR6","doi-asserted-by":"publisher","first-page":"411","DOI":"10.1016\/0167-6296(91)90023-G","volume":"10","author":"A Blomqvist","year":"1991","unstructured":"Blomqvist, A.: The doctor as double agent: Information asymmetry, health insurance, and medical care. J. Health Econ. 10(4), 411\u2013432 (1991)","journal-title":"J. Health Econ."},{"issue":"9","key":"1826_CR7","doi-asserted-by":"publisher","first-page":"1114","DOI":"10.1002\/hec.3893","volume":"28","author":"D Burkhard","year":"2019","unstructured":"Burkhard, D., Schmid, C.P.R., W\u00fcthrich, K.: Financial incentives and physician prescription behavior: Evidence from dispensing regulations. Health Econ. 28(9), 1114\u20131129 (2019)","journal-title":"Health Econ."},{"key":"1826_CR8","doi-asserted-by":"crossref","unstructured":"Callaway, B.: Difference-in-differences for policy evaluation. Handbook of Labor, Human Resources and Population Economics, pp. 1\u201361 (2023)","DOI":"10.1007\/978-3-319-57365-6_352-1"},{"key":"1826_CR9","doi-asserted-by":"crossref","unstructured":"Cattaneo, M.D., Idrobo, N., Titiunik, R.: A practical introduction to regression discontinuity designs: Extensions. Cambridge University Press (2024)","DOI":"10.1017\/9781009441896"},{"issue":"12","key":"1826_CR10","doi-asserted-by":"publisher","first-page":"e82990","DOI":"10.1371\/journal.pone.0082990","volume":"8","author":"GL Colombo","year":"2013","unstructured":"Colombo, G.L., Agabiti-Rosei, E., Margonato, A., Mencacci, C., Montecucco, C.M., Trevisan, R.: Off-patent generic medicines vs. off-patent brand medicines for six reference drugs: A retrospective claims data study from five local healthcare units in the Lombardy region of Italy. PloS One 8(12), e82990 (2013)","journal-title":"PloS One"},{"key":"1826_CR11","doi-asserted-by":"publisher","first-page":"153","DOI":"10.1016\/j.jhealeco.2019.03.006","volume":"65","author":"G Crea","year":"2019","unstructured":"Crea, G., Galizzi, M.M., Linnosmaa, I., Miraldo, M.: Physician altruism and moral hazard: (No) Evidence from Finnish national prescriptions data. J. Health Econ. 65, 153\u2013169 (2019)","journal-title":"J. Health Econ."},{"key":"1826_CR12","doi-asserted-by":"crossref","unstructured":"Currie, J., Li, A., Schnell, M.: The effects of competition on physician prescribing. Technical report, National Bureau of Economic Research (2023)","DOI":"10.3386\/w30889"},{"key":"1826_CR13","unstructured":"European Commission: Pharmaceutical strategy for Europe. https:\/\/eur-lex.europa.eu\/legal-content\/EN\/TXT\/PDF\/?uri=CELEX:52020DC0761. Communication from the Commission to the European Parliament, the Council, the European Economic and Social Committee and the Committee of the Regions, COM(2020) 761 final (2020)"},{"issue":"7","key":"1826_CR14","doi-asserted-by":"publisher","first-page":"599","DOI":"10.1002\/(SICI)1099-1050(199911)8:7<599::AID-HEC479>3.0.CO;2-K","volume":"8","author":"JM Ferr\u00e1ndiz","year":"1999","unstructured":"Ferr\u00e1ndiz, J.M.: The impact of generic goods in the pharmaceutical industry. Health Econ. 8(7), 599\u2013612 (1999)","journal-title":"Health Econ."},{"key":"1826_CR15","unstructured":"Ferre, F., Giulio\u00a0de Belvis, A., Valerio, L., Longhi, S., Lazzari, A., Fattore, G., Ricciardi, W., Maresso, A.: Italy: Health system review (health systems in transition no. 16) (2014)"},{"key":"1826_CR16","first-page":"573","volume":"61","author":"JE Gersen","year":"2008","unstructured":"Gersen, J.E., Posner, E.A.: Soft law: Lessons from congressional practice. Stan. L. Rev. 61, 573 (2008)","journal-title":"Stan. L. Rev."},{"issue":"4","key":"1826_CR17","doi-asserted-by":"publisher","first-page":"411","DOI":"10.1097\/00005650-197904000-00009","volume":"17","author":"T Goldberg","year":"1979","unstructured":"Goldberg, T., DeVito, C.A., Smith, D., Stano, M., Vidis, J.S., Moore, W.E., Dickson, W.M.: Evaluation of economic effects of drug product selection legislation. Med. Care 17(4), 411\u2013419 (1979)","journal-title":"Med. Care"},{"issue":"11","key":"1826_CR18","doi-asserted-by":"publisher","first-page":"1643","DOI":"10.1016\/j.socscimed.2009.09.016","volume":"69","author":"D Granlund","year":"2009","unstructured":"Granlund, D.: Are private physicians more likely to veto generic substitution of prescribed pharmaceuticals? Soc. Sci. Med. 69(11), 1643\u20131650 (2009)","journal-title":"Soc. Sci. Med."},{"issue":"2","key":"1826_CR19","doi-asserted-by":"publisher","first-page":"149","DOI":"10.1007\/s10742-022-00284-w","volume":"23","author":"BA Griffin","year":"2023","unstructured":"Griffin, B.A., Schuler, M.S., Pane, J., Patrick, S.W., Smart, R., Stein, B.D., Grimm, G., Stuart, E.A.: Methodological considerations for estimating policy effects in the context of co-occurring policies. Health Serv. Outcomes Res. Methodol. 23(2), 149\u2013165 (2023)","journal-title":"Health Serv. Outcomes Res. Methodol."},{"issue":"1","key":"1826_CR20","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1007\/s41999-018-0140-5","volume":"10","author":"M Guti\u00e9rrez-Valencia","year":"2019","unstructured":"Guti\u00e9rrez-Valencia, M., Mart\u00ednez-Velilla, N., Vilches-Moraga, A.: Polypharmacy in older people: Time to take action. Eur. Geriatr. Med. 10(1), 1\u20133 (2019)","journal-title":"Eur. Geriatr. Med."},{"issue":"8","key":"1826_CR21","doi-asserted-by":"publisher","first-page":"2047","DOI":"10.1007\/s11255-023-03516-1","volume":"55","author":"G Hawthorne","year":"2023","unstructured":"Hawthorne, G., Lightfoot, C.J., Smith, A.C., Khunti, K., Wilkinson, T.J.: Multimorbidity prevalence and patterns in chronic kidney disease: Findings from an observational multicentre UK cohort study. Int. Urol. Nephrol. 55(8), 2047\u20132057 (2023)","journal-title":"Int. Urol. Nephrol."},{"key":"1826_CR22","doi-asserted-by":"publisher","first-page":"60","DOI":"10.1186\/s40545-020-00269-5","volume":"13","author":"H H\u00e5konsen","year":"2020","unstructured":"H\u00e5konsen, H., W\u00e4ngberg, M., Alani, D., Hedenrud, T.: Generic versus brand-name over-the-counter analgesics: Knowledge and attitudes among Swedish pharmacy customers. J. Pharm. Policy Pract. 13, 60 (2020)","journal-title":"J. Pharm. Policy Pract."},{"issue":"6","key":"1826_CR23","doi-asserted-by":"publisher","first-page":"2826","DOI":"10.1257\/aer.102.6.2826","volume":"102","author":"T Iizuka","year":"2012","unstructured":"Iizuka, T.: Physician agency and adoption of generic pharmaceuticals. Am. Econ. Rev. 102(6), 2826\u20132858 (2012)","journal-title":"Am. Econ. Rev."},{"key":"1826_CR24","unstructured":"Italian Medicines Agency (AIFA): Comunicato aifa 24\/2024. (2024). https:\/\/www.aifa.gov.it\/documents\/20142\/2317348\/Comunicato_AIFA_24-2024_EN.pdf. Accessed 13 Feb 2025"},{"key":"1826_CR25","doi-asserted-by":"publisher","first-page":"364","DOI":"10.1016\/j.jebo.2019.12.022","volume":"172","author":"Y Ito","year":"2020","unstructured":"Ito, Y., Hara, K., Kobayashi, Y.: The effect of inertia on brand-name versus generic drug choices. J. Econ. Behav. Organ. 172, 364\u2013379 (2020)","journal-title":"J. Econ. Behav. Organ."},{"key":"1826_CR26","unstructured":"Jommi, C., Armeni, P., De\u00a0Luca, C.: Il governo regionale dell\u2019assistenza farmaceutica e il suo impatto sulla spesa. Egea (2011)"},{"key":"1826_CR27","doi-asserted-by":"crossref","unstructured":"Kahan, D.M.: Gentle nudges vs. hard shoves: Solving the sticky norms problem. U. Chi. L. Rev., pp. 607\u2013645 (2000)","DOI":"10.2307\/1600336"},{"key":"1826_CR28","unstructured":"Law 122\/2010: Conversione in legge, con modificazioni, del decreto-legge 31 maggio 2010, n. 78, recante misure urgenti in materia di stabilizzazione finanziaria e di competitivita\u2019 economica. (10G0146) (2010)"},{"key":"1826_CR29","unstructured":"Law 27\/2012: Conversione, con modificazioni, del decreto-legge 24 gennaio 2012, n. 1: Misure urgenti in materia di concorrenza, liberalizzazioni e infrastrutture. Official Government Legislation (2012)"},{"issue":"1","key":"1826_CR30","doi-asserted-by":"publisher","first-page":"33","DOI":"10.1016\/j.pharp.2025.02.002","volume":"1","author":"M Liu","year":"2025","unstructured":"Liu, M., Yao, L.: The effect of USA state generic substitution laws on the generic utilization and market competition. Pharmacoecon. Policy 1(1), 33\u201341 (2025)","journal-title":"Pharmacoecon. Policy"},{"issue":"2","key":"1826_CR31","doi-asserted-by":"publisher","first-page":"103","DOI":"10.5582\/ddt.2020.01011","volume":"14","author":"S Lu","year":"2020","unstructured":"Lu, S., Cai, J., Xu, F.: Ultra-low price of generic agents in China may weaken patients\u2019 drug recognition and compliance. Drug Discov. Ther. 14(2), 103\u2013104 (2020)","journal-title":"Drug Discov. Ther."},{"issue":"8","key":"1826_CR32","doi-asserted-by":"publisher","first-page":"1264","DOI":"10.1002\/hec.3774","volume":"27","author":"GJ Pruckner","year":"2018","unstructured":"Pruckner, G.J., Schober, T.: Hospitals and the generic versus brand-name prescription decision in the outpatient sector. Health Econ. 27(8), 1264\u20131283 (2018)","journal-title":"Health Econ."},{"issue":"2","key":"1826_CR33","doi-asserted-by":"publisher","first-page":"115","DOI":"10.1007\/s10754-013-9126-5","volume":"13","author":"M Rischatsch","year":"2013","unstructured":"Rischatsch, M., Trottmann, M., Zweifel, P.: Generic substitution, financial interests, and imperfect agency. Int. J. Health Care Finance Econ. 13(2), 115\u2013138 (2013)","journal-title":"Int. J. Health Care Finance Econ."},{"issue":"10","key":"1826_CR34","doi-asserted-by":"publisher","first-page":"1372","DOI":"10.1007\/s11606-014-2933-7","volume":"29","author":"RJ Romanelli","year":"2014","unstructured":"Romanelli, R.J., Segal, J.B.: Predictors of statin compliance after switching from branded to generic agents among managed-care beneficiaries. J. Gen. Intern. Med. 29(10), 1372\u20131378 (2014)","journal-title":"J. Gen. Intern. Med."},{"issue":"10","key":"1826_CR35","doi-asserted-by":"publisher","first-page":"1736","DOI":"10.1016\/j.jval.2022.03.012","volume":"25","author":"BN Rome","year":"2022","unstructured":"Rome, B.N., Sarpatwari, A., Kesselheim, A.S.: State laws and generic substitution in the year after new generic competition. Value Health 25(10), 1736\u20131742 (2022)","journal-title":"Value Health"},{"key":"1826_CR36","doi-asserted-by":"publisher","first-page":"7","DOI":"10.1007\/BF00055564","volume":"1","author":"W Samuelson","year":"1988","unstructured":"Samuelson, W., Zeckhauser, R.: Status quo bias in decision making. J. Risk Uncertain. 1, 7\u201359 (1988)","journal-title":"J. Risk Uncertain."},{"key":"1826_CR37","doi-asserted-by":"publisher","first-page":"835","DOI":"10.3389\/fneur.2018.00835","volume":"9","author":"G Saposnik","year":"2018","unstructured":"Saposnik, G., Mamdani, M., Terzaghi, M., Saladino, M.L., Silva, B., Tobler, P.N., Caceres, F.: The role of prescribing generic (non-proprietary) drugs in the prevalence of therapeutic inertia in multiple sclerosis care. Front. Neurol. 9, 835 (2018)","journal-title":"Front. Neurol."},{"issue":"4","key":"1826_CR38","doi-asserted-by":"publisher","first-page":"456","DOI":"10.1016\/j.healthpol.2014.12.018","volume":"119","author":"C Schaumans","year":"2015","unstructured":"Schaumans, C.: Prescribing behavior of general practitioners: Competition matters. Health Policy 119(4), 456\u2013463 (2015)","journal-title":"Health Policy"},{"issue":"7","key":"1826_CR39","doi-asserted-by":"publisher","first-page":"1383","DOI":"10.1377\/hlthaff.2009.0424","volume":"29","author":"WH Shrank","year":"2010","unstructured":"Shrank, W.H., Choudhry, N.K., Agnew-Blais, J., Federman, A.D., Liberman, J.N., Liu, J., Kesselheim, A.S., Brookhart, M.A., Fischer, M.A.: State generic substitution laws can lower drug outlays under Medicaid. Health Aff. 29(7), 1383\u20131390 (2010)","journal-title":"Health Aff."},{"issue":"11","key":"1826_CR40","doi-asserted-by":"publisher","first-page":"1406","DOI":"10.1016\/j.healthpol.2015.09.007","volume":"119","author":"LN Skaltsas","year":"2015","unstructured":"Skaltsas, L.N., Vasileiou, K.Z.: Patients\u2019 perceptions of generic drugs in Greece. Health Policy 119(11), 1406\u20131414 (2015)","journal-title":"Health Policy"},{"key":"1826_CR41","doi-asserted-by":"publisher","first-page":"204","DOI":"10.1016\/j.socscimed.2015.01.013","volume":"130","author":"N Skipper","year":"2015","unstructured":"Skipper, N., Vejlin, R.: Determinants of generic vs. brand drug choice: Evidence from population-wide Danish data. Soc. Sci. Med. 130, 204\u2013215 (2015)","journal-title":"Soc. Sci. Med."},{"key":"1826_CR42","doi-asserted-by":"publisher","first-page":"204","DOI":"10.1016\/j.socscimed.2015.01.013","volume":"130","author":"N Skipper","year":"2015","unstructured":"Skipper, N., Vejlin, R.: Determinants of generic vs. brand drug choice: Evidence from population-wide Danish data. Soc. Sci. Med. 130, 204\u2013215 (2015)","journal-title":"Soc. Sci. Med."},{"issue":"11","key":"1826_CR43","doi-asserted-by":"publisher","first-page":"1717","DOI":"10.1002\/hec.3796","volume":"27","author":"Y Song","year":"2018","unstructured":"Song, Y., Barthold, D.: The effects of state-level pharmacist regulations on generic substitution of prescription drugs. Health Econ. 27(11), 1717\u20131737 (2018)","journal-title":"Health Econ."},{"key":"1826_CR44","doi-asserted-by":"crossref","unstructured":"Sorenson, C., Drummond, M., Bhuiyan Khan, B.: Medical technology as a key driver of rising health expenditure: Disentangling the relationship. Clinicoecon. Outcomes Res., 223\u2013234 (2013)","DOI":"10.2147\/CEOR.S39634"},{"issue":"7","key":"1826_CR45","doi-asserted-by":"publisher","first-page":"e0297019","DOI":"10.1371\/journal.pone.0297019","volume":"19","author":"ST Stoffel","year":"2024","unstructured":"Stoffel, S.T., Spencer, R., Konya, J., Vlaev, I., Schwenkglenks, M.: Herding-like behaviour in medical decision making: An experimental study investigating general practitioners\u2019 prescription behaviour. Plos One 19(7), e0297019 (2024)","journal-title":"Plos One"},{"issue":"1","key":"1826_CR46","doi-asserted-by":"publisher","first-page":"169","DOI":"10.1007\/s00181-019-01674-9","volume":"59","author":"M Tang","year":"2020","unstructured":"Tang, M., Wu, Y.: Medical providers as double agents in a universal health care system: Evidence from generic pharmaceutical adoption in Taiwan. Empir. Econ. 59(1), 169\u2013203 (2020)","journal-title":"Empir. Econ."},{"issue":"1","key":"1826_CR47","doi-asserted-by":"publisher","first-page":"94","DOI":"10.1111\/coep.12430","volume":"38","author":"S Terrizzi","year":"2020","unstructured":"Terrizzi, S., Meyerhoefer, C.: Estimates of the price elasticity of switching between branded and generic drugs. Contemp. Econ. Policy 38(1), 94\u2013108 (2020)","journal-title":"Contemp. Econ. Policy"}],"container-title":["The European Journal of Health Economics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s10198-025-01826-y.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s10198-025-01826-y","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s10198-025-01826-y.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,2]],"date-time":"2026-04-02T11:21:02Z","timestamp":1775128862000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s10198-025-01826-y"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,9,2]]},"references-count":47,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2026,3]]}},"alternative-id":["1826"],"URL":"https:\/\/doi.org\/10.1007\/s10198-025-01826-y","relation":{},"ISSN":["1618-7598","1618-7601"],"issn-type":[{"value":"1618-7598","type":"print"},{"value":"1618-7601","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,9,2]]},"assertion":[{"value":"19 March 2025","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"4 August 2025","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"2 September 2025","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The Authors have no competing interests.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing Interests"}},{"value":"Ethics approval is not required for this study.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics Statement"}},{"value":"All Authors have agreed with the content and have explicitly consented to submit the paper and the revision. Where needed, consent was obtained from the responsible authorities where the work was carried out, before the work was submitted.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for Publication"}},{"value":"The research did not need human consent as the data did not involve human subjects.","order":5,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent to Participate"}}]}}