Does the Identity of the Third-Party Payer Matter for Prescribing Doctors?
Abstract
TNF-alpha inhibitors represent one of the most important areas of biopharmaceuticals by sales, with three blockbusters accounting for 8 per cent of total pharmaceutical sale in Norway. Novelty of the paper is to examine, with the use of a unique natural policy experiment in Norway, to what extent the price responsiveness of prescription choices is affected when the identity of the third-party payer changes. The three dominating drugs in this market, Enbrel, Remicade, and Humira, are substitutes, but have had different and varying funding schemes - hospitals and the national insurance plan. A stochastic structural model for the three drugs, covering demand and price setting, is estimated in a joint maximum likelihood approach. We find that doctors are more responsive when the costs are covered by the hospitals compared to when costs are covered by national insurance.
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Arrow, K.J., (1963), “The Welfare Economics of Medical Care”, American Economic Review, 53, 941–973.
Bathon J, R. Martin, and R. Fleischmann (2000), “A comparison of etanercept and methotrexate in patients with early rheumatoid arthritis”, N. Engl. J. Med.,Vol. 343, pp. 1586-1583.
Berndt E.R., R.S. Pindyck - P. Azoulay (2003), “Consumption Externalities and Diffusion in PharmaceuticalMarkets: Antiulcer Drugs”, Journal of Industrial Economics, 243-270.
Berry, S, J. Levinsohn and A. Pakes (1995), “Automobile prices in market equilibrium”, Econometrica 63,pp. 841-899.
Contoyannis, P., J. Hurley, P. Grootendorst, S-H. Jung, and R. Tamblyn (2005), “Estimating the price elasticity of expenditure for prescription drugs in the presence of non-linear price schedules”, Health Economics, Vol. 14, pp. 909-923.
Coscelli, A. (2000), “The importance of Doctors’ and Patients’ Preferences in the Prescription Decision”, Journal of Industrial Economics, Vol. 3, pp. 349-369.
Coscelli, A and M. Shum (2004), “An empirical model of learning and patient spillovers in new drug entry”, Journal of Econometrics, Vol. 122, pp. 213-246.
Ellison, S.F., I. Cockburn, Z. Griliches, and J. Hausman (1997), “Characteristics of demand for pharmaceutical products: an examination of four cephalosporins”, Rand Journal of Economics, Vol. 28, pp. 426-446.
Feldmann M., and R.N. Maini (2003), “TNF defined as a therapeutic target for rheumatoid arthritis and other autoimmune diseases”, Nature Medicine, 9(10), pp. 1245-1250.
Haavelmo, T. (1944): “The Probability Approach in Econometrics”, Supplement to Econometrica, Vol 12, July
Hellerstein J. (1998), “The importance of physician in the generic versus-trade name prescription decision”, Rand Journal of Economics, Vol. 29, pp. 109-136.
Iizuka, T. (2007), “Experts’Agency Problems: Evidence from the Prescription Drug Market in Japan”, Rand Journal of Economics, Vol. 38, pp. 844–862.
Leibowitz, A., W.G. Manning, J.P. Newhouse (1985), “The demand for prescription drugs as a function of cost-charing”, Social Science and Medicine, Vol. 21, pp. 1063-1069.
Lipsky P., D. Van Der Heijde, E.W. St Clair, and D.E. Furst (2000), “Infliximab and methotrexate in the treatment of rheumatoid arthritis”. New Engl. J. Med., 343 (22), pp.1594-1602.
Lundin, D. (2000), “Moral hazard in physician prescription behaviour”, Journal of Health Economics, Vol. 19, pp. 639-662.
McGuire, T. G. (2000). “Physician Agency,” in A.J. Cuyler and J.P. Newhouse, Handbook of Health Economics, North-Holland, 467-536.
Moreland, L.W., S.W. Baumgartner, and M.H. Schiff (1997), “Treatment of rheumatoid arthritis with a recombinant human tumor necrosis factor receptor (p75)–Fc fusion protein, N.Engl. J. Med. 337, 141-7.
Norwegian Association of Pharmaceutical Manufacturers, Facts and Figures (2009), http://www.legemiddelstatistikk.com/tf/2009/tall_og_fakta_2009.pdf.
O’Brien, B. (1989): “The effect of patient charges on the utilisation of prescription medicines”, Journal of Health Economics, Vol. 8, pp.109-132.
Train, K. E., 2009:”Discrete Choice Methods with Simulation”, Second Edition, Cambridge: Cambridge University Press.
Walsh, G., 2003, “Biopharmaceutical benchmarks”, Nat.Biotechnol. 21 (8), pp. 865-870.
Weinblatt M.E., J.M. Kremer, A.D. Bankhurst, and K.J. Bulpitt (1999), “A trial of etanercept, a recombinant tumor necrosis factor receptor:Fc fusion protein, in patients with rheumatoid arthritis receiving methotrexate”. New Engl. J. Med. 340 (4), 253-259.
DOI: https://doi.org/10.11114/aef.v1i1.324
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