University of Rosario (Bogota), Colombia.
J Health Econ. 2010 Mar;29(2):303-16. doi: 10.1016/j.jhealeco.2009.11.015. Epub 2009 Dec 3.
Our paper is a first attempt to evaluate the long run impact of reference pricing on pharmaceutical innovation, health and expenditures. The model is based on a dynamic game involving three types of agents: pharmaceutical firms, consumers and a regulatory entity. Pharmaceutical firms choose the level of research investment and its innovative content, then negotiate introductory prices for new drugs with the regulator. Reference pricing affects negatively the intensity of research and it also modifies the types of innovations that are brought to the market, deterring small innovations. The model is calibrated with a small data on statins in France. Our results suggest that reference pricing typically generates a decline in health, whereas discounted expenditures may decrease or increase, depending on the degree of deterrence of cost reducing innovations.
我们的论文首次尝试评估参考定价对药品创新、健康和支出的长期影响。该模型基于一个涉及三种类型的主体的动态博弈:制药公司、消费者和监管实体。制药公司选择研究投资水平和创新内容,然后与监管机构协商新药的入门价格。参考定价会对研究的强度产生负面影响,还会改变推向市场的创新类型,阻碍小型创新。该模型是根据法国他汀类药物的少量数据进行校准的。我们的研究结果表明,参考定价通常会导致健康状况下降,而折扣支出可能会减少或增加,这取决于对降低成本创新的抑制程度。