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1 – 10 of over 4000This paper aims to study the post-patent ethical drug market and simulate the impact of Patient Protection and Affordable Care Act (ACA) on individuals, health-care providers and…
Abstract
Purpose
This paper aims to study the post-patent ethical drug market and simulate the impact of Patient Protection and Affordable Care Act (ACA) on individuals, health-care providers and pharmaceutical firms. US policymakers have been looking at various ways to curb rising health-care costs in USA, including ways to promote the use of generic drugs in lieu of brand drugs. In this broader context, the implementation of ACA in December 2013 will introduce major changes in the pharmaceutical market.
Design/methodology/approach
To fully understand the impact of such policy changes, we develop a structural model to study consumers’ buying behavior and firm competition in the post-patent ethical drug markets. We use the estimated model parameters to conduct four policy simulations to illustrate the effect of Obamacare on increasing the relative size of price-insensitive segment, reducing price sensitivity in the price-sensitive segment, providing brand price discount to Medicare patients previously in the “donut hole” and the effect of change in people’s attitude toward generics.
Findings
Our model estimation reveals two classes of consumers with different price sensitivities. This heterogeneity explains the increase in the brand price after generic entry. We identify consumers’ switching costs between generic and brand drugs, as well as among different generics. From the policy simulation, we find that except the closure of Medicare donut hole, all other policy changes lead to increased usage of the focal molecule, and the efforts to increase insurance coverage and reduce the out of pocket payment for prescription drugs lead to increase in firm profit.
Originality/value
This paper is the first to illustrate the potential policy effect of Obamacare through a structural model on post-patent ethical drug market.
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Kathleen Iacocca, James Sawhill and Yao Zhao
This paper aims to investigate why brand-name drugs are priced higher than their generic equivalents in the US market. The authors hypothesize that some consumers have a…
Abstract
Purpose
This paper aims to investigate why brand-name drugs are priced higher than their generic equivalents in the US market. The authors hypothesize that some consumers have a preference for brand names, which outweighs the cost savings realized by switching to generics. Consumers may prefer a brand drug because the brand may have a higher perceived quality due to advertising and other promotional activities. Additionally, individuals are habitual in their consumption of prescription drugs, which leads to continued use of the brand in the face of generic competition.
Design/methodology/approach
The authors develop a structural demand model and proceed to estimate it using wholesale price and demand data from the years 2000 through 2004.
Findings
The results of our analysis reveal that customers have a strong preference for brand drugs. In addition, consumers exhibit high switching costs for prescription drugs.
Originality/value
Considering the price and quantity of prescriptions filled each day, determining why brand drugs do not lower their prices to compete with their generic equivalents is an important question. Unfortunately, the existing literature only acknowledges this counter-intuitive business practice, but does not mathematically explain it. The authors address this knowledge gap in literature and provide important insight for all players in this industry including consumers, pharmaceutical manufacturers and health insurance companies.
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Yu Yu and Sachin Gupta
The purpose of this paper is to take a close look at competition among the generic entrants during the first three years after patent expiration and examine whether there is a…
Abstract
Purpose
The purpose of this paper is to take a close look at competition among the generic entrants during the first three years after patent expiration and examine whether there is a first mover advantage. Pharmaceutical markets experience the entry of numerous generic firms upon expiration of the brand firm’s patent.
Design/methodology/approach
A random effect nested logit model of competition that allows for competition between the brand drug and generics, and among multiple generic drugs is specified. The model accommodates the effects of prices, detailing, sampling, journal advertising, time-in-market and molecule-specific characteristics. The model is estimated on cross-section time-series data for 49 molecules in which the brand drug lost patent exclusivity between 1992 and 2000.
Findings
Strong evidence that the early generic entrant enjoys a substantial market share and profit advantage over the second and the third entrants, after controlling for differences in marketing activities was found. In addition, evidence suggesting that the advantage is due to the response of the retail pharmacy channel and due to differential effectiveness of advertising and pricing between earlier versus later entrants was found.
Originality/value
This paper is the first to empirically model first mover advantage among undifferentiated products. The findings are useful for regulators in pharmaceutical and healthcare industries. They can also shed light on other industries where there is little or no quality differentiation, such as commodity trading, open-source software distribution and online banking.
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This research studies the effect of deregulation of price cap in pharmaceutical market. Price regulation (either through price cap or reference price) is common practice in the…
Abstract
Purpose
This research studies the effect of deregulation of price cap in pharmaceutical market. Price regulation (either through price cap or reference price) is common practice in the pharmaceutical market but recently there are increasing voices calling for deregulation claiming that deregulation could help in lowering drug price and increase revenue of pharmaceutical firms. Upon those callings, Chinese government removed the price cap regulation in June 2015. The author uses this natural policy experiment to study this effect.
Design/methodology/approach
In this study, the author applied the interrupted time series analysis (ITSA) on the revenue data of nine categories of both generic and branded drugs in China from March 2011 to August 2016 (the time frame includes both before and after of the initialization of the deregulation) and analyzed the effect of deregulation.
Findings
The results showed that, whether the revenue of drugs will increase or decrease after the deregulation of price cap depends on the level of competition and the change of patterns of the branded and generic drugs are different. When HHI (Herfindahl–Hirschman index) is sufficiently low (competition is high), revenue does not change as a result of deregulation, when HHI is moderately low (moderate competition), revenue from generic drugs will decrease significantly and revenue from branded drugs will increase significantly, and when HHI is high (low competition), revenue from generic drugs will increase significantly and revenue from branded drugs will decrease significantly.
Originality/value
This is a unique study with a unique data set. Most previous studies focus on regulation of drug price and analyze how this may affect drug revenue; however, this is a natural policy experiment of de-regulation. Moreover, previously most studies focus on reference pricing regulation and this is price-cap, a different mechanism that is rarely studied. The originality/value is high of this article.
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Andrea Sestino and Cesare Amatulli
This study aims at exploring the role of perceived disease seriousness in consumers’ preference for generic versus branded drugs, by shedding light on new factors impacting…
Abstract
Purpose
This study aims at exploring the role of perceived disease seriousness in consumers’ preference for generic versus branded drugs, by shedding light on new factors impacting consumer purchase behaviour for pharmaceutical products.
Design/methodology/approach
An exploratory study based on a quantitative analysis has been conducted with a sample of 100 participants who have been presented with two different scenarios: one related to more serious disease (as in cardiological disease) and one related to less serious disease (as in the seasonal flu). This paper considered Italy as a research setting where the recent mandatory prescription of the active ingredient by doctors leaves the final purchase decision in consumers’ hands
Findings
Results show that, although consumers are free to choose whether to buy a branded or a generic prescribed active ingredient, their choice is mainly driven by the role of the brand. Consumers’ intention to buy generic drugs is higher in the case of diseases perceived as less serious, while the intention to buy branded drugs is higher in the case of disease perceived as more serious.
Originality/value
This study contributes to marketing research and practice by proposing that consumers’ perceived seriousness of their disease should be considered as a further factor in identifying new marketing strategies in those contexts in which the choice between branded or generic drugs is free.
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Purpose – To examine how drug prices for specific diseases vary across payers in the United States and how insurer and patient out-of-pocket (OOP) costs vary by payer…
Abstract
Purpose – To examine how drug prices for specific diseases vary across payers in the United States and how insurer and patient out-of-pocket (OOP) costs vary by payer type.
Methodology – This study uses data from the Medical Expenditure Panel Survey (MEPS) from 1996 to 2006. We estimate multivariate price regressions for four major drug product classes (antihypertensive, antidepressant, antiasthma drugs, and non-steroidal anti-inflammatory drugs (NSAIDs)). Separate models are estimated for brand and generic drugs within each of these drug product classes. In addition to estimating overall transaction price equations for brands and generics, the study estimates patient OOP payments and insurer payments for drugs.
Findings – We find relatively modest differences among payers in terms of total prices (e.g., insurer plus OOP). The main difference is in terms of how prices were shared between insurers and patients. Medicaid paid significantly more than other payers for each drug class, while Medicaid beneficiaries paid significantly less.
Research implications – Our results shed light on how drug prices vary by different payers and how drug prices are shared by third party payers and patients. The relatively modest differences in total drug prices across payer type suggest that these payers do not differ greatly in terms of their ability to negotiate price concessions from their suppliers. Instead, larger differences emerge in terms of how total costs are shared among the payer and their patients. Understanding the reasons for these variations, and their implications for health outcomes, are important directions for further research.
Chon Kit Chao, Hao Hu, Liming Zhang and Jihong Wu
The paper aims to study how global pharmaceutical companies such as Pfizer have managed the challenges of pharmaceutical patent expiry.
Abstract
Purpose
The paper aims to study how global pharmaceutical companies such as Pfizer have managed the challenges of pharmaceutical patent expiry.
Design/methodology/approach
A case study method was applied. The best-selling brand drug over the past 10 years – Lipitor – was chosen as the case target.
Findings
For dealing with this, this paper describes all the details of the corresponding strategies of Pfizer before and after patent expiration of Lipitor. Before patent expiry, Pfizer undertook the activities of direct-to-consumer marketing, pricing strategy for competition, legal delay and me-too drug R&D. After patent expiry, Pfizer chose to carry out continuous marketing for brand, rebate strategy, authorized generics and change to over-the-counter. In addition, diversity and globalization strategy was applied before and after patent expiry.
Research limitations/implications
This research provides strong implication for managing pharmaceutical products before and after patent expiry.
Practical implications
It is strongly recommended for both brand and generic drug companies to design strategies to meet the challenges of pharmaceutical patent expiry.
Social implications
For the global pharmaceutical market, a conclusion can be drawn that, nowadays, the “patent cliff” is the most significant factor influencing decision-makers to consider futuristic policies. Further, it is also a considerably effective solution for reducing health-care costs for policymakers.
Originality/value
This paper contributes to the field of patent expiry management in high-tech industries such as pharmaceuticals.
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With expenditures totaling $227 billion in 2007, prescription drug purchases are a growing portion of the total medical expenditure, and as this industry continues to grow…
Abstract
With expenditures totaling $227 billion in 2007, prescription drug purchases are a growing portion of the total medical expenditure, and as this industry continues to grow, prescription drugs will continue to be a critical part of the larger health care industry. This chapter presents a survey on the economics of the US pharmaceutical industry, with a focus on the role of R&D and marketing, the determinants (and complications) of prescription drug pricing, and various aspects of consumer behavior specific to this industry, such as prescription drug regulation, the patient's interaction with the physician, and insurance coverage. This chapter also provides background in areas not often considered in the economics literature, such as the role of pharmacy benefit managers in prescription drug prices and the differentiation between alternative measures of prescription drug prices.
Details
Keywords
- Abbreviated New Drug Application (ANDA)
- Average Manufacturer Price (AMP)
- Average Wholesale Price (AWP)
- Bayh-Dole Act
- Bioequivalence
- Brand name drug
- Center for Medicare and Medicaid Services (CMS)
- Chain pharmacy
- Clinical trials
- Closed formulary
- Coinsurance
- Compliance
- Co-payment
- Cost controls
- Cost sharing
- Detailing
- Direct-to-consumer Advertising (DTC Advertising)
- Disease management
- Drug manufacturers
- Drug prices
- Drug–product substitution
- Experience goods
- Fee-for-service (FFS)
- First-mover advantage
- Food and Drug Administration (FDA)
- Formulary
- Generic drug
- Good Manufacturing Processes (GMP)
- Hatch-Waxman Act
- Health plan
- Insurance
- Investigational New Drug Application (IND)
- Mail-order pharmacy
- Mail-order prescription drugs
- Medicaid
- Medicare
- Medicare+Choice (M+C)
- Medicare Advantage
- Medicare Modernization Act (MMA)
- Medicare Part D
- Moral hazard
- Negative goods
- New Drug Application (NDA)
- Non-retail pharmacy
- Original Medicare
- Out-of-pocket
- Paid search advertising
- Patent
- Patient
- Pharmaceutical
- Pharmacy
- Pharmacy benefit manager (PBM)
- Physician
- Prescription drugs
- Product differentiation
- Rebate
- Reimbursement
- Research and development (R&D)
- Retail pharmacy
- Search costs
- Switching costs
- Therapeutic class
- Third-party insurance
- Tiered formulary
- Wholesale Acquisition Price (WAC)
- Wholesaler
Alice M. Tybout, Julie Hennessy, Natalie Fahey and Charlotte Snyder
The case tells the story of Synthroid from its development in 1958 as the first synthetic thyroxine molecule to its competition against generic equivalents in 2004. The case…
Abstract
The case tells the story of Synthroid from its development in 1958 as the first synthetic thyroxine molecule to its competition against generic equivalents in 2004. The case introduces students to the pharmaceutical industry, its practices, and some of the complexities of pricing and drug choice, with drug manufacturers, insurance companies, physicians, pharmacists, and patients all playing a role. It also provides a primer on hypothyroidism, its symptoms, and its treatment.
Because Synthroid was developed and introduced before FDA regulations and drug standards of identity were fully established, it was difficult for competitors to get their drugs certified as identical to Synthroid. Through a series of efforts with physicians, especially endocrinologists, Synthroid's owners were able to maintain the perception for forty-six years that Synthroid was uniquely effective. In 2004, however, the FDA declared several competitive products to be bioequivalent to Synthroid, which posed a significant challenge to its owner, Abbott Laboratories. Students are challenged to consider options to maintain the drug's unit volume, revenue, and/or profit in these difficult circumstances.
The case is written in two parts. The (A) case provides background on the history of the drug, the pharmaceutical industry and its marketing practices, and hypothyroidism and its treatment, and it concludes in 2004 as Abbott's marketers face the impending challenge of defending the Synthroid business against generic competition. The (B) case describes what Abbott actually did to maintain its share in the United States and outlines its strategy in India, a market without patent protection for pharmaceuticals.
After analyzing the case students should be able to:
Describe strategies that branded competitors can use to defend their business from lower-priced competition
Understand the basics of pharmaceutical marketing and pricing, including the global challenge of defending branded drugs against generic equivalents
Discuss ethical issues in the marketing of high-margin branded products that have lower-priced alternatives, especially in the healthcare industry
Describe strategies that branded competitors can use to defend their business from lower-priced competition
Understand the basics of pharmaceutical marketing and pricing, including the global challenge of defending branded drugs against generic equivalents
Discuss ethical issues in the marketing of high-margin branded products that have lower-priced alternatives, especially in the healthcare industry
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Adam Gailey, Darius Lakdawalla and Neeraj Sood
Purpose – To evaluate the efficiency consequences of the Medicare Part D program.Methods – We develop and empirically calibrate a simple theoretical model to examine the static…
Abstract
Purpose – To evaluate the efficiency consequences of the Medicare Part D program.
Methods – We develop and empirically calibrate a simple theoretical model to examine the static and the dynamic welfare effects of Medicare Part D.
Findings – We show that Medicare Part D can simultaneously reduce static deadweight loss from monopoly pricing of drugs and improve incentives for innovation. We estimate that even after excluding the insurance value of the program, the welfare gain of Medicare Part D roughly equals its social costs. The program generates $5.11 billion of annual static deadweight loss reduction and at least $3.0 billion of annual value from extra innovation.
Implications – Medicare Part D and other public prescription drug programs can be welfare-improving, even for risk-neutral and purely self-interested consumers. Furthermore, negotiation for lower branded drug prices may further increase the social return to the program.
Originality – This study demonstrates that pure efficiency motives, which do not even surface in the policy debate over Medicare Part D, can nearly justify the program on their own merits.