Ernst Berndt (MIT Sloan School of Management and NBER) Iain Cockburn (University of British Columbia and NBER) Douglas Cocks (Eli Lilly and Company) Arnold Epstein (Harvard Medical School) Zvi Griliches (Harvard University and NBER)
Additional information is available for the following
registered author(s):
Recently controversy has surrounded the issue of whether Social Security payments to the elderly should continue to be adjusted automatically according to changes in the Consumer Price Index (CPI). One issue in the public policy debate concerns whether price inflation is different for the elderly, particularly because the official Bureau of Labor Statistics price indexes for medical care have been growing more rapidly than the overall CPI, and medical care expenditures constitute a larger proportion of the elderly's budget than of the young's.Using annual IMS data from 1990 to 1996, we examine empirically whether elderly-nonelderly price inflation differentials exist for prescription pharmaceuticals. We assess prices for prescription drugs destined for ultimate use by the elderly versus the nonelderly at three points in the distribution chain: initial sales from manufacturers, intermediate purchases by retail pharmacies, and final sales from retail pharmacies to patients or payors. We find that at the initial point in the distribution chain, no differences in price inflation exist for the aggregate of drugs destined for use by the elderly versus those for the nonelderly. At the intermediate sell-in point to pharmacy distribution, we examine antibiotics (ABs), antidepressants (ADs), and calcium channel blockers (CCBs). For ABs, since 1992 price inflation has been somewhat greater for the elderly than for the young, reflecting in part the elderly's more intensive use of newer branded products having fewer side effects, adverse drug interactions and more convenient dosing--attributes of particular importance to the elderly. For ADs, price inoation is considerably less for the elderly than for the young, due in large part to the elderly's greater use of older generic products. For CCBs, elderly-nonelderly differentials are negligible. None of these differentials adjust for variations in quality.At the final retail sell-out point, we examine only ADs. We find that because retailers obtain larger gross margins on generic than on branded products, and because the elderly are disproportionately large users of generic ADs, the elderly-nonelderly price inflation differential benefiting the elderly at the intermediate point is reduced considerably at final sale.
Download Info
To download:
If you experience problems downloading a file, check if you have the
proper application to
view it first. Information about this may be contained
in the File-Format links below. In case of further problems read
the IDEAS help
file. Note that these files are not on the IDEAS
site. Please be patient as the files may be large.
As the access to this document is restricted, you may want to look for a different version under "Related research" (further below) or search for a different version of it.
References listed on IDEAS Please report citation or reference errors to , or , if you are the registered author of the cited work, log in to your RePEc Author Service profile, click on "citations" and make appropriate adjustments.:
David M. Cutler & Mark McClellan & Joseph P. Newhouse & Dahlia Remler, 1996.
"Are Medical Prices Declining?,"
NBER Working Papers
5750, National Bureau of Economic Research, Inc.
[Downloadable!] (restricted)
Cited by: (explanations, Please report citation or reference errors to , or , if you are the registered author of the cited work, log in to your RePEc Author Service profile, click on "citations" and make appropriate adjustments.)