Norwegian School of Economics (NHH), Department of Economics, Centre for Business Economics, Helleveien 30, Bergen N-5045, Norway.
BI Norwegian Business School, Oslo N-0442, Norway.
J Health Econ. 2022 May;83:102613. doi: 10.1016/j.jhealeco.2022.102613. Epub 2022 Mar 19.
Two-part pricing (the Netflix model) has recently been proposed instead of uniform pricing for pharmaceuticals. Under two-part pricing the health plan pays a fixed fee for access to a drug at unit prices equal to marginal costs. Despite two-part pricing being socially efficient, we show that the health plan is worse off when the drug producer is a monopolist, as all surplus is extracted. This result is reversed with competition, as two-part pricing yields higher patient utility and lower drug costs for the health plan. However, if we allow for exclusive contracts, uniform pricing is preferred by the health plan. The choice of payment scheme is also shown to influence on the incentives to spend resources on drastic innovations relative to incremental, me-too innovations.
两部分定价（Netflix 模式）最近被提议用于替代药品的统一定价。在两部分定价下，健康计划支付固定的访问费用，单位价格等于边际成本。尽管两部分定价在社会上是有效的，但我们表明，当药品生产商是垄断者时，健康计划的情况会更糟，因为所有的剩余都被提取出来了。有了竞争，这种结果就会逆转，因为两部分定价会提高患者的效用，并降低健康计划的药品成本。然而，如果我们允许独家合同，健康计划则更倾向于统一定价。支付方案的选择也被证明会影响相对于渐进式、跟风式创新，在资源投入方面的激励措施。
