Duesseldorf Institute for Competition Economics (DICE), Heinrich Heine University, Germany.
TILEC and Department of Economics, Tilburg University, The Netherlands.
J Health Econ. 2017 Dec;56:19-29. doi: 10.1016/j.jhealeco.2017.08.008. Epub 2017 Sep 15.
Health insurance companies curb price-insensitive behavior and the moral hazard of insureds by means of cost-sharing, such as tiered co-payments or reference pricing in drug markets. This paper evaluates the effect of price limits - below which drugs are exempt from co-payments - on prices and on demand. First, using a difference-in-differences estimation strategy, we find that the new policy decreases prices by 5 percent for generics and increases prices by 4 percent for brand-name drugs in the German reference price market. Second, estimating a nested-logit demand model, we show that consumers appreciate co-payment exempt drugs and calculate lower price elasticities for brand-name drugs than for generics. This explains the different price responses of brand-name and generic drugs and shows that price-related co-payment tiers are an effective tool to steer demand to low-priced drugs.
医疗保险公司通过共付额分级或药品市场的参考定价等成本分担方式来抑制价格不敏感行为和被保险人的道德风险。本文评估了价格限制（低于该价格的药品免于共付额）对价格和需求的影响。首先，我们使用双重差分估计策略发现，新政策使德国参考价格市场中的仿制药价格降低了 5%，而品牌药价格则上涨了 4%。其次，通过嵌套逻辑需求模型估计，我们表明消费者对免共付额的药品有更高的评价，并计算出品牌药的价格弹性低于仿制药，这解释了品牌药和仿制药价格反应的不同，并表明与价格相关的共付额层级是引导需求转向低价药品的有效工具。
