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Insurer Bargaining and Negotiated Drug Prices in Medicare Part D

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Author Info
Darius Lakdawalla
Wesley Yin
Abstract

A controversial feature of Medicare Part D is its reliance on private insurers to negotiate drug prices and rebates with retail pharmacies and drug manufacturers. Central to this controversy is whether increases in market power—an undesirable feature in most settings—confer benefits in health insurance markets, where larger buyers may obtain better prices for their members. We test whether insurers that experience larger enrollment increases due to Part D negotiate lower drug prices with pharmacies. Overall, we find that 100,000 additional insureds lead to 2.5-percent lower pharmacy prices negotiated by the insurer, and 5-percent reductions in pharmacy profits earned on prescriptions filled by enrollees of that insurer. Estimated enrollment effects are much larger for drugs with therapeutic substitutes, and virtually zero for branded drugs without therapeutic substitutes. We also present evidence that most insurer savings are, on the margin, passed on as lower premiums. Out-of-sample estimation suggests that modest insurer consolidation would generate significant savings to Medicare, along with premium reductions and enrollment increases. Finally, we find that greater enrollment leads to lower pharmacy prices negotiated by insurers for their non-Part D market—an external benefit to the commercially enrolled associated with administering Part D through private insurers.

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Paper provided by National Bureau of Economic Research, Inc in its series NBER Working Papers with number 15330.

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Date of creation: Sep 2009
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Handle: RePEc:nbr:nberwo:15330

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Find related papers by JEL classification:
I1 - Health, Education, and Welfare - - Health
I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health

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  1. Claudio Lucarelli & Jeffrey Prince & Kosali Simon, 2008. "Measuring Welfare and the Effects of Regulation in a Government-Created Market: The Case of Medicare Part D Plans," NBER Working Papers 14296, National Bureau of Economic Research, Inc. [Downloadable!] (restricted)
  2. Alexander Raskovich, 2003. "Pivotal Buyers and Bargaining Position," Journal of Industrial Economics, Blackwell Publishing, vol. 51(4), pages 405-426, December. [Downloadable!] (restricted)
  3. Stole, Lars A & Zwiebel, Jeffrey, 1996. "Organizational Design and Technology Choice under Intrafirm Bargaining," American Economic Review, American Economic Association, vol. 86(1), pages 195-222, March. [Downloadable!] (restricted)
  4. Richard T. Carson & Yixiao Sun, 2007. "The Tobit model with a non-zero threshold," Econometrics Journal, Royal Economic Society, vol. 10(3), pages 488-502, November. [Downloadable!] (restricted)
  5. Katherine Ho, 2009. "Insurer-Provider Networks in the Medical Care Market," American Economic Review, American Economic Association, vol. 99(1), pages 393-430, March. [Downloadable!]
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This page was last updated on 2009-12-14.


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