Search results

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.

Robert Hauptman first raised awareness about the ethical issues of reference service in 1976. Hauptman, a library school student at the time, did a study on the culpability, or lack thereof, in reference service provided by librarians. In his study, Hauptman posed as a library patron seeking potentially dangerous information. The behavior examined was how librarians respond to the request for material on how to build a bomb that would be powerful enough to blow up a house. Hauptman tried to present himself as a person of questionable character. He used six public and seven academic libraries in this study. Hauptman first made sure that he was speaking to the reference librarian. He then requested information for the construction of a small explosive, requesting specifically the chemical properties of cordite. He then asked for information on the potency of such an explosive, whether or not it could blow up a suburban house (Hauptman, Wilson Library Bulletin, 1976, p. 626).

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.

Brand-name pharmaceutical companies have engaged in a variety of business conduct that has increased price. One of these activities involves “product hopping,” or brand switches from one version of a drug to another. The antitrust analysis of product hopping implicates antitrust law, patent law, the Hatch–Waxman Act, and state drug product selection laws, as well as uniquely complicated markets characterized by buyers different from decision makers. As a result, courts have offered inconsistent approaches to product hopping.

In this chapter, we offer a framework that courts and government enforcers can employ to analyze product hopping. The framework is the first to incorporate the characteristics of the pharmaceutical industry. It defines a “product hop” to include instances in which the manufacturer (1) reformulates the product to make the generic nonsubstitutable and (2) encourages doctors to write prescriptions for the reformulated rather than the original product.

When the conduct meets both requirements, our framework offers two stages of analysis. First, we propose two safe harbors to ensure that the vast majority of reformulations will not face antitrust review. Second, the framework examines whether the hop passes the “no-economic-sense” test, determining if the behavior would make economic sense if the hop did not have the effect of impairing generic competition. Showing just how far the courts have veered from justified economic analysis, the test would recommend a different analysis than that used in each of the five product-hopping cases that have been litigated to date, and a different outcome in two of them.

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.

The identification of country-specific advantages for business activities is one of the most crucial issues of strategic management and international business literatures. We address this issue by examining location-specific conditions for a successful generic medicines industry within 24 European countries. The findings of our fuzzy-set qualitative comparative analysis show that there are no necessary conditions for the high performance or absence of the high-performance industry. By revealing the causal complexity related to the issue, however, we show that the high performance or lack of it results from a configuration of conditions. Specifically, we identify two sufficient causal configurations to both outcomes. These findings provide clear implications for generic medicines industry firms who are planning location choices of their operations. In addition, this study provides a methodological advancement to explain and understand which country elements matter more, for what outcomes, and under what conditions.

This chapter proposes authentic leadership as a generic competence and an integral part of doctoral education regardless of field of study. The authors explore its potential to enhance the development of doctoral candidates and academics and search for answers to the questions: Can and should authentic leadership be developed as a generic competence in doctoral education? How can it be designed and implemented in a doctoral training module? What would its learning outcomes be? The authors address these questions in the context of doctoral education. They assert that authentic leadership training should be mandatory for all doctoral candidates, and that supervisors should be actively engaged in the development of this underappreciated transferrable skill.

The Federal Trade Commission (FTC) has initiated policies and legal challenges that have shaped the evolution of competition in healthcare. This chapter discusses not only discusses the current matters in healthcare competition, but it also gives a history of past issues faced by the FTC and the approaches used to resolve them. These FTC actions range from challenges to hospital mergers to preventing “reverse payments” from patent holders to generic entrants in pharmaceuticals. Ultimately the healthcare industry faces many unique regulatory and competitive aspects that, while challenging, do not require special rules.

Purpose – Agribusiness is crucial for the Brazilian trade balance surplus. Innovation, not only that focused on technology or productivity, is a basic condition for its development. The context of the agribusiness activities in a developing country is dynamic and requires a multilevel and multifaceted view. This suggests that these features need to be incorporated both in the theories and methods. Therefore, we propose a method, from within the perspective of Configurations Theory, of capturing this dynamic multidimensionality. The method was applied in the context of the rice-farming business in Southern Brazil.

Methodology/approach – The proposed method, which we refer to as a Case Study Method with Multiple Units of Analysis and Mixed Methods, was applied in a research organization in an attempt to identify the evolution of innovation while considering a theoretical perspective based on multilevel rules.

Findings – Six different configurations in the temporal organization of research were identified. These six configurations describe the evolution of four emphases given to innovation, the drivers associated with the evolution of these emphases, and the changes that have occurred over time.

Social implications – The results may provide support for new public policies for rice farming and lead to improvements in the organization's strategies for innovation.

Originality/value of chapter – The combination of methods used (Case Study, Qualitative Comparative Analysis, Social Network Analysis, Path Dependence, and Patterns of Decision Making) to study configurations, together with the dynamic approach to innovation based on multilevel rule, is unique.

Tooling is a common component of an industrial product’s manufacture. Specific tooling is devised to serve the fabrication of a particular product, while generic tooling can be used in the manufacture of multiple products. In the latter case, companies are confronted with the problem of fairly allocating the indirect costs of the tooling. This article studies how to allocate costs of generic tooling to single production orders.

Ten allocation methods (AMs) are described that are in principle suited to the distribution of generic tooling costs to production orders. Since the presented methods have for the most part been discussed in differing contexts, we apply them to a specified generic tooling problem for comparison. Evaluation of the various methods is based on 16 criteria. Reasoning is supported by a computational Monte Carlo simulation. Furthermore, we suggest using the Analytical Hierarchy Process (AHP) to elaborate one final proposition concerning the most preferable allocation scheme.

The article reports the single allocation rules’ performances for different allocation scenarios. The described characteristics refer to fairness, efficiency, and simplicity as well as to empty-core performance. Using AHP analysis allows for the aggregation of the rules’ criteria ratings. Thus, especially suitable allocation schemes for the problem at hand are identified.

An allocation is required for budgeting reasons and also for the definition of projects’ bottom-up sales prices. Selecting the “right” AM is important, as a suboptimal AM can result in unfair allocation vectors, which will act as incentives to stop using the common resource, potentially leading to higher total costs.

Research on the comparison of AMs is typically performed for certain purposes, such as enterprise networks, horizontal cooperative purchasing scenarios, or municipal service units. This article will augment the research evaluating AMs by introducing a novel set of evaluation criteria and by providing an in-depth comparison of AMs suited for the allocation of generic tooling costs.