Competition and substitutability in the Swedish pharmaceuticals market

Rudholm, Niklas

doi:10.1080/0003684032000125042

Cited by 38 publications

(58 citation statements)

References 14 publications

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“…Their estimates range from −0.38 to −4.34. Our results could also be compared to the ones found in Rudholm (2003), who derives own-price elasticities for three Swedish pharmaceuticals submarkets for each year between 1989-1996. However, it is the prescription drug market for beta-receptor blocking agents that may be most similar to our outpatient antibiotic market, although not identical.…”

Section: Resultsmentioning

confidence: 83%

Small area variations and welfare loss in the use of outpatient antibiotics

Filippini

Masiero

Moschetti

2008

HEP

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Objective: This paper seeks to explain local variations in the use of antibiotics in the community and to assess the welfare loss due to heterogeneous attitudes towards the risk of bacterial resistance.Method: Quarterly data on antibiotic sales from 240 small areas in Switzerland over the course of one year are used. An econometric ad-hoc model with spatial lags is proposed in which the demand for antibiotics varies according to the socioeconomic characteristics of the population, the incidence of infections, antibiotic price and local health care supply. Using residual variations we then evaluate the welfare loss due to varying antibiotic prescription styles.Results: Significant differences are observed in the per capita antibiotic consumption across local areas. Individual income, the demographic structure of the population, physician density and the price of drugs are all relevant determinants. We estimate that unexplained variations may account for 12% of the total antibiotic spending in the community, thus leading to a €6.8 ml loss per year.Conclusions: The understanding of determinants of variations in outpatient antibiotic consumption may help to design more effective policies to counter the threat of bacterial resistance. Our estimate of the welfare loss due to heterogeneous attitudes towards antibiotic treatment is comparable to the expected cost of implementing measures to improve the dissemination of information on bacterial resistance among patients and doctors.

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Section: Resultsmentioning

confidence: 83%

Small area variations and welfare loss in the use of outpatient antibiotics

Filippini

Masiero

Moschetti

2008

HEP

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“…Applications of INAR(p) processes in the medical sciences can be found in, for example, Franke and Seligmann (1993) and Cardinal et al (1999); applications to economics in, for example, Böckenholt (1999), Berglund and Brännäs (2001), Brännäs and Hellström (2001), Rudholm (2001), Böckenholt (2003), Brännäs and Shahiduzzaman (2004), Freeland and McCabe (2004), and Gourieroux and Jasiak (2004).…”

Section: Here Z (Ti) Jmentioning

confidence: 99%

Local Asymptotic Normality and Efficient Estimation for INAR(p) Models

Drost

Akker²,

Werker

2006

SSRN Journal

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Integer-valued autoregressive (INAR) processes have been introduced to model nonnegative integervalued phenomena that evolve in time. The distribution of an INAR(p) process is determined by two parameters: a vector of survival probabilities and a probability distribution on the nonnegative integers, called an immigration or innovation distribution. This paper provides an efficient estimator of the parameters, and in particular, shows that the INAR(p) model has the Local Asymptotic Normality property.

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“…In the next section, we will describe our sample of substances more carefully. 23 For more details see the webpage of the Norwegian Medicines Agency www.legemiddelverket.no. 24 The pharmacies are obliged to have at least one drug version priced at (or below) the RP (trinnpris) available for sale.…”

Section: Institutional Backgroundmentioning

confidence: 99%

“…Eventually, after (at least) 18 months the regulator can increase the discount up to a maximum of 90 percent for the substances with the highest sales value. 23 Patients who purchase a product that is priced higher than the reference price have to pay the full price difference out-of-pocket in addition to the standard coinsurance payment. Notably, this part of the patients' copayments have to be paid irrespectively of whether the accumulated medical costs exceed the expenditure caps described above.…”

Section: Institutional Backgroundmentioning

confidence: 99%

“…In Section 2 we present a general framework to illustrate the main theoretical mechanisms which determine the relationship between RP and generic entry. In Section 3 we describe the institutional framework of the Norwegian 8 See, for instance, Grabowski and Vernon (1992), Frank and Salkever (1997), Scott Morton (1999Morton ( , 2000, Reiffen and Ward (2005) for generic entry in the more unregulated US pharmaceutical market, and Rudholm (2001) and Iizuka (2009) for generic entry in the more regulated Swedish and Japanese markets, respectively.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Does Reference Pricing Drive Out Generic Competition in Pharmaceutical Markets? Evidence from a Policy Reform.

2015

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Re ef fe er re en nc ce e P Pr ri ic ci in ng g D Dr ri iv ve e O Ou ut t G Ge en ne er ri ic c C Co om mp pe et ti it ti io on n i in n P June 2015AbstractIn this paper we study the impact of reference pricing (RP) on entry of generic firms in the pharmaceutical market. For given prices, RP increases generic firms' expected profit, but since RP also stimulates price competition, the impact on generic entry is theoretically ambiguous. In order to empirically test the effects of RP, we exploit a policy reform in Norway in 2005 that exposed a subset of drugs to RP. Having detailed product-level data for a wide set of substances from 2003 to 2013, we find that RP increased the number of generic drugs. We also find that RP increased market shares of generic drugs, reduced the prices of both branded and generic drugs, and led to a (weakly significant) decrease in total drug expenditures. The reduction in total expenditures was relatively smaller than the reduction in average prices, reflecting the fact that lower prices stimulated total demand.

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Competition and substitutability in the Swedish pharmaceuticals market

Cited by 38 publications

References 14 publications

Small area variations and welfare loss in the use of outpatient antibiotics

Small area variations and welfare loss in the use of outpatient antibiotics

Local Asymptotic Normality and Efficient Estimation for INAR(p) Models

Does Reference Pricing Drive Out Generic Competition in Pharmaceutical Markets? Evidence from a Policy Reform.

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