Voters’ response to in-kind transfers: Quasi-experimental evidence from prescription drug cost-sharing in Brazil

In metropolitan areas the Brazilian government provides drugs against hypertension and diabetes for free, and against other diseases 90 percent below market price. A city’s eligibility for these in-kind transfers changes exogenously at given city population thresholds. We compare vote shares of mayors around these thresholds. Regression discontinuity estimates suggest that the program increases incumbent mayors’ vote shares between 11 and 17 percentage points. This is larger than the electoral return of cash transfer programs reported by the existing literature, lending support to theories that in-kind transfers get more voter support despite being less cost-effective. •First quasi-experimental estimates of the electoral rewards of prescription drug cost-sharing.•Results suggest electoral rewards between 11 and 17 percentage points for incumbent mayors.•Lends support to theories that in-kind transfers get more voter support than cash transfers.