Mahjoub Reza, Ødegaard Fredrik, Zaric Gregory S
Department of Emergency Medicine Research, University of Alberta, Edmonton, Alberta, Canada.
Ivey Business School, Western University, London, Ontario, Canada.
Health Econ. 2018 Jan;27(1):e15-e25. doi: 10.1002/hec.3522. Epub 2017 Jun 19.
We analyze a game-theoretic model of a risk-sharing agreement between a payer and a pharmaceutical firm. The drug manufacturer chooses the price while the payer sets the rebate rate and decides which patients are eligible for treatment. The manufacturer provides the payer with a rebate for nonresponding patients. We generalize on the existing literature, by making both price and rebate rate decision variables, allowing the rebate rate to be different from 100%, and incorporating 2 types of administrative costs. We identify a threshold for the expected probability of response for classifying the drug as a mass-market or niche type and investigate the optimal solutions for both types. We also identify a threshold for the rebate rate at which the net benefits become equal for responding and nonresponding patients. Through numerical examples, we examine how various parameters impact the drug manufacturer's and the payer's optimal solution.
我们分析了支付方与制药公司之间风险分担协议的博弈论模型。药品制造商确定价格，而支付方设定回扣率并决定哪些患者有资格接受治疗。制造商为无反应患者向支付方提供回扣。我们在现有文献的基础上进行了拓展，将价格和回扣率都作为决策变量，允许回扣率不同于100%，并纳入了两种行政成本。我们确定了将药物分类为大众市场型或利基型的反应预期概率阈值，并研究了这两种类型的最优解。我们还确定了一个回扣率阈值，在该阈值下，有反应和无反应患者的净收益相等。通过数值示例，我们研究了各种参数如何影响药品制造商和支付方的最优解。
