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Price elasticities of pharmaceuticals in a value based‐formulary setting

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  • Kai Yeung
  • Anirban Basu
  • Ryan N. Hansen
  • Sean D. Sullivan

Abstract

Empirical estimates of price elasticities of demand (PED) for pharmaceuticals suggest that they are relatively price inelastic. However, in many settings, a medication and its substitutes and complements face simultaneous differential changes in prices that affect the observed “composite” PED. We exploit an implementation of a value‐based formulary (VBF) that utilized drug‐specific incremental cost‐effectiveness ratios (ICERs) to inform drug copayments, resulting in increases in copayments for some medications and decreases in copayments for others. We first show theoretically that by changing the price of a medication and its substitute in opposite directions, VBF designs can leverage cross‐price effects to increase the range of composite PEDs. We then empirically estimate PED and welfare effects using a consumer surplus approach. Overall PED was −0.16, similar to the RAND Health Insurance Experiment estimate. However, there was substantial dispersion of PED across the VBF copayment tiers ranging from −0.09 to −0.87 with a statistically significant trend aligned with the levels of value as reflected by the ICER estimates (p

Suggested Citation

  • Kai Yeung & Anirban Basu & Ryan N. Hansen & Sean D. Sullivan, 2018. "Price elasticities of pharmaceuticals in a value based‐formulary setting," Health Economics, John Wiley & Sons, Ltd., vol. 27(11), pages 1788-1804, November.
    • Handle: RePEc:wly:hlthec:v:27:y:2018:i:11:p:1788-1804
    DOI: 10.1002/hec.3801
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    1. Mark Duggan & Fiona Scott Morton, 2010. "The Effect of Medicare Part D on Pharmaceutical Prices and Utilization," American Economic Review, American Economic Association, vol. 100(1), pages 590-607, March.
    2. Manning, Willard G, et al, 1987. "Health Insurance and the Demand for Medical Care: Evidence from a Randomized Experiment," American Economic Review, American Economic Association, vol. 77(3), pages 251-277, June.
    3. Paul Contoyannis & Jeremiah Hurley & Paul Grootendorst & Sung‐Hee Jeon & Robyn Tamblyn, 2005. "Estimating the price elasticity of expenditure for prescription drugs in the presence of non‐linear price schedules: an illustration from Quebec, Canada," Health Economics, John Wiley & Sons, Ltd., vol. 14(9), pages 909-923, September.
    4. Zeckhauser, Richard, 1970. "Medical insurance: A case study of the tradeoff between risk spreading and appropriate incentives," Journal of Economic Theory, Elsevier, vol. 2(1), pages 10-26, March.
    5. repec:mpr:mprres:5585 is not listed on IDEAS
    6. Gaynor Martin & Li Jian & Vogt William B, 2007. "Substitution, Spending Offsets, and Prescription Drug Benefit Design," Forum for Health Economics & Policy, De Gruyter, vol. 10(2), pages 1-33, July.
    7. Ai, Chunrong & Norton, Edward C., 2003. "Interaction terms in logit and probit models," Economics Letters, Elsevier, vol. 80(1), pages 123-129, July.
    8. Anirban Basu & Bhakti V. Arondekar & Paul J. Rathouz, 2006. "Scale of interest versus scale of estimation: comparing alternative estimators for the incremental costs of a comorbidity," Health Economics, John Wiley & Sons, Ltd., vol. 15(10), pages 1091-1107, October.
    9. Keeler, Emmett B. & Rolph, John E., 1988. "The demand for episodes of treatment in the health insurance experiment," Journal of Health Economics, Elsevier, vol. 7(4), pages 337-367, December.
    10. Daryl Pregibon, 1980. "Goodness of Link Tests for Generalized Linear Models," Journal of the Royal Statistical Society Series C, Royal Statistical Society, vol. 29(1), pages 15-24, March.
    11. Michael Grossman, 1999. "The Human Capital Model of the Demand for Health," NBER Working Papers 7078, National Bureau of Economic Research, Inc.
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    Cited by:

    1. Li, Dong & Dong, Chuanwen, 2022. "Government regulations to mitigate the shortage of life-saving goods in the face of a pandemic," European Journal of Operational Research, Elsevier, vol. 301(3), pages 942-955.

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