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The Supreme Court’s decision in Federal Trade Commission v. Actavis, Inc. is a challenge to conventional antitrust analysis. Conventional civil antitrust cases are decided by a preponderance of the evidence. This means that conduct challenged under the rule of reason is only condemned if the conduct resulted in more competitive harm in the actual world than a world without the alleged violation. Under conventional analysis, the intent of the parties also plays only a supporting role in determining whether the conduct was anticompetitive. A holder of a valid patent has a right to exclude others practicing the patented technology. And, the patent holder is not assumed to have market power because it expended resources in maintaining exclusionary rights. Actavis creates doubts about these propositions in circumstances beyond the “reverse” payment settlement of a patent suit that may have delayed an alleged infringer market entry. This chapter explores whether applying Actavis logic to antitrust litigation can result in condemnation of practices where there is little chance of an anticompetitive effect, where the patent holder likely has a valid and infringed patent, where there is little reason to believe that the patent holder has market power, and where only one party, or no parties, to an agreement have an anticompetitive intent. This chapter also investigates whether Actavis creates new problems with standing analysis, damages calculations, and the balancing of efficiencies against anticompetitive effects. Nevertheless, the lower courts have begun to extend the logic of Actavis. This is apparent in the condemnation of no-Authorized-generic settlements.

Intentions of managers of pharmaceutical multinational enterprises (MNEs) to adopt business strategies, which will aid global health and wellbeing, are in some ways linked with their understanding of the returns that their company will receive from these investments. However, the MNE’s managers are unaware of business strategies that will allow them to link their business activities with the corporate objectives of contributing to Sustainable Development Goals (SDGs). Pharmaceutical companies are moving toward monopolistic practices by acquiring local companies for manufacturing purposes or by engaging local companies in contract manufacturing and directing the focus of these companies away from innovation and toward profit making. At the same time, pharmaceutical MNEs are promoting global health and wellbeing as their SDGs. This study uses knowledge from existing sources and expert insights to explain the returns that MNEs can get from their investments related to global health and wellbeing. One of the important recommendations from the ethical point of view is engaging local firms in the innovation process; from the marketing perspective, this study recommends the use of a corporate brand and not a product brand for offering generic medicines. The operations perspective explains how MNEs can incorporate the social agenda into their mainstream business strategies. Limitations of the study are discussed, and avenues for future research are explained.

This study examines the empirical relationship between four broad antecedents of brand equity (branding strategy, brand structure, brand positioning and target market) and two separate dimensions of revenue premium: price premium and volume premium. Our modeling framework aims to explain how different antecedents of brand equity influence the realized velocity and margin of branded product sales, key drivers of operating cash flow. Our generalizable empirical analyses are based on a representative dataset of over 6,500 brands, across 200 consumer-packaged goods categories, spanning three years. We find that only 20% of brands command revenue premiums, for which volume premiums are the critical determinant. Branding strategies and brand structure primarily impact volume premium. In contrast, brand positioning has little effect. Target market substantially affects both premiums. Overall, these four elements account for 73% and 69% of the explained variations in price and volume premiums, respectively. This study provides generalizable, important, and novel insights for the theory and practice of brand management regarding price positioning and extending brands into new categories.

Purpose – Pharmaceutical expenditures have an important role in Europe. The attempts to control expenditure have used a wide range of policy measures. We reviewed the main measures adopted by the European Union countries, especially in countries where governments are the largest third-party payers.

Methodology – To complement a literature review on the topic, data was gathered from national reviews of health systems and direct inquiries to several government bodies.

Findings – Almost all countries regulate prices of pharmaceutical products. Popular policy measures include international referencing to set prices (using as benchmark countries that have set lower prices), internal reference pricing systems to promote price competition in domestic markets, and positive lists for reimbursement to promote consumption of generics (including in some cases substitution by pharmacists of drugs prescribed by physicians). Despite the wide range of policy measures, it is not possible to identify a “silver bullet” to control pharmaceutical expenditures. We also identified two main policy challenges: policy coordination among countries within the European Union to maintain incentives for R&D at the global level, and the development of new relationships with the pharmaceutical industry; namely, the so-called risk-sharing agreements between the pharmaceutical industry and governments/regulators (or large third-party payers).

Purpose – The purpose of this study is to estimate the own- and cross-price elasticity of brand-name outpatient prescription drug cost-sharing for maintenance medications and to estimate the effects of changes in the price differential between generic and brand-name prescription drugs.

Methodology/approach – We first review the literature on the effects of an increase in brand-name drug patient cost-sharing. In addition, we analyze two examples of utilization patterns in filling behavior associated with an increase in brand-name cost-sharing for patients in employer-sponsored health plans with chronic illness.

Findings – We found that the own-price elasticity of demand for brand-name prescription drugs was inelastic. However, the cross-price elasticity was not consistent in sign, and utilization patterns for generic prescription fills did not always increase after a rise in brand-name cost-sharing.

Research limitations – The empirical examples are limited to the experience of patients with employer-sponsored health insurance.

Practical implications – The common practice of increasing brand-name prescription drug patient cost-sharing to increase consumption of generic drugs may not always result in higher generic medication use. Higher brand-name drug cost-sharing levels may result in discontinuation of chronic therapies, instead of therapeutic switching.

Originality/value of chapter – The value of this chapter is its singular focus on the effects of higher brand-name drug cost-sharing through a synthesis of the literature examining the own- and cross-price elasticity of demand for brand-name medications and two empirical examples of the effects of changes in brand-name cost-sharing.

This chapter aims at casting some doubts on the idea that branding techniques can be easily adopted by destination management organizations. They lack many of the tools that have proved successful in marketing most goods and services. To shed some light on the issue, the chapter focuses on the imaging/branding policies of the Spanish National Tourism Organization between 1959 and 1979. If measured by the inflow of international tourists to the country, they should be deemed extremely well implemented. However, it is difficult to reach this conclusion. The study examines Spanish poster production—one of the most efficient promotional tools of the time—and draws some lessons on how it is possible to be successful in spite of their destination marketing organizations.

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.

Purpose – To analyse the development of pharmaceutical policy in the Dutch market for outpatient prescription drugs since the early 1990s.

Methodology – A literature review and document analysis is performed to examine the effects of pharmaceutical policy on the performance of the Dutch market for outpatient prescription drugs since the early 1990s.

Findings – Government efforts to control prices of pharmaceuticals were effective in constraining prices of in-patent drugs, but had an opposite effect on the prices of generic drugs. The gradual transition towards managed competition – that particularly gained momentum after the introduction of the new universal health insurance scheme in 2006 – appears to be more effective in constraining prices of generic drugs than earlier government efforts to control these prices.

Originality – Comparative analysis of the impact of price regulation and managed competition on generic drug prices in the Netherlands.

Implications – Implications of the changing role of health insurers are discussed for the future market for prescription drugs and role of pharmacies in the Netherlands.

Purpose – This study examines the effect of price regulation and competition on launch timing and pricing of new drugs.

Methods – Our data cover launch experience in 15 countries from 1992 to 2003 for drugs in 12 major therapeutic classes. We estimate a two-equation model of launch hazard and launch price of new drugs.

Findings – We find that launch timing and prices of new drugs are related to a country's average prices of established products in a class. Thus to the extent that price regulation reduces price levels, such regulation directly contributes to launch delay in the regulating country. Regulation by external referencing, whereby high-price countries reference low-price countries, also has indirect or spillover effects, contributing to launch delay and higher launch prices in low-price referenced countries.

Implications – Referencing policies adopted in high-price countries indirectly impose welfare loss on low-price countries. These findings have implications for US proposals to constrain pharmaceutical prices through external referencing and drug importation.