Econ Papers Daily / 期刊论文
药品价格监管中的市场规模与策略互动
Market size and strategic interaction in pharmaceutical price regulation
摘要
We present a model of optimal regulation in the presence of spillover effects and asymmetric countries, and we use it to study strategic interaction among countries in pharmaceutical price regulation, where the spillovers result from innovation in drug development. Regulators' pricing decisions affect welfare both directly and indirectly, via firms' R&D policies. We characterize two types of equilibrium, depending on whether countries price at, or above, the minimum level the industry is willing to accept to serve the market. The combination of these two equilibria may imply a U‐shaped relationship between countries' pharmaceutical prices and relative market size. Using data for 83 cancer drugs across 23 OECD countries, our empirical analysis supports this hypothesis, with results being robust to correcting for the impact of confidential price discounts and a range of different model specifications. Our findings contribute to the academic debate about the relationship between prices and market size, as well as the policy debate about using supranational procurement policies to lower prices. In particular, we show that joint procurement can lower or raise prices according to the sizes of the domestic markets that join to create a single purchasing authority.
中文摘要
我们构建了一个在存在溢出效应与不对称国家情形下的最优规制模型，并以此研究各国在药品价格规制中的策略互动，其中溢出效应源于药物研发领域的创新。监管者的定价决策通过企业的研发政策，既直接又间接地影响社会福利。我们刻画了两种均衡类型，其区分依据在于各国定价是处于行业愿意接受以服务市场的最低水平，还是高于该水平。这两种均衡的组合可能意味着国家间药品价格与相对市场规模之间存在U型关系。利用涵盖23个OECD国家、83种抗癌药物的数据，我们的实证分析支持了这一假设，且结果在考虑保密性价格折扣的影响及多种不同模型设定后依然稳健。我们的发现为关于价格与市场规模关系的学术辩论，以及关于运用超国家集中采购政策以降低价格的政策讨论均作出了贡献。特别是，我们表明，联合采购根据组成单一采购机构的各国内部市场规模的不同，既可能降低也可能抬高价格。