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The biopharmaceutical industry has been a major driver of
technological change in health care, producing unprecedented
benefits for patients, cost challenges for payers, and profits for
shareholders. As consumers and companies benefit from access to new
drugs, policymakers around the globe seek mechanisms to control
prices and expenditures commensurate with value. More recently the
1990s productivity boom of new products has turned into a
productivity bust, with fewer and more modest innovations, and flat
or declining revenues for innovative firms as generics replace
their former blockbuster products. This timely volume examines the
economics of the biopharmaceutical industry, with 18 chapters by
leading academic health economists. Part one examines the economics
of biopharmaceutical innovation including determinants of the costs
and returns to new drug development; how capital markets finance
R&D and how costs of financing the biopharmaceutical industry
compare to financing costs for other industries; the effects of
safety and efficacy regulation by the Food and Drug Administration
(FDA) and of price and reimbursement regulation on incentives for
innovation; and the role of patents and regulatory exclusivities.
Part two examines the market for biopharmaceuticals with chapters
on prices and reimbursement in the US, the EU, and other
industrialized countries, and in developing countries. It looks at
the optimal design of insurance for drugs and the effects of cost
sharing on spending and on health outcomes; how to measure the
value of pharmaceuticals using pharmacoeconomics, including theory,
practical challenges, and policy issues; how to measure
pharmaceutical price growth over time and recent evidence;
empirical evidence on the value of pharmaceuticals in terms of
health outcomes; promotion of pharmaceuticals to physicians and
consumers; the economics of vaccines; and a review of the evidence
on effects of mergers, acquisitions and alliances. Each chapter
summarizes the latest insights from theory and recent empirical
evidence, and outlines important unanswered questions and areas for
future research. Based on solid economics, it is nevertheless
written in terms accessible to the general reader. The book is thus
recommended reading for academic economists and non-economists, and
for those in industry and policy who wish to understand the
economics of this fascinating industry.
This study examines the effect of existing regulations on US
pharmaceutical firms. The author explores the indirect spillovers
from the regulatory use of international price comparisons and the
threat from parallel trade, concluding that competition promises
more efficiency and incentives.
Drug coverage for seniors is better addressed by private-sector
plans than by forcing manufacturers to offer Federal Supply
Schedule discounts to the retail sector.
In the 1980s and early 1990s, America's system of workers'
compensation insurance was in trouble. As medical costs grew and
benefits and compensable injuries expanded, costs of this insurance
skyrocketed. In response, the states imposed price controls, but
those controls caused unforeseen - and negative - consequences. The
authors define the problems, trace the regulatory responses, and
analyze the effects of rate regulation. Their study illuminates how
rate regulation set up to control the cost of workers' compensation
insurance reduced incentives for safety and cost control and
subsidized high-risk activities and firms at the expense of others.
This text pinpoints the loss in economic efficiency from global
budgeting and its likely distributive effects.
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