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Preventives Versus Treatments

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  • Michael Kremer
  • Christopher M. Snyder

Abstract

Preventives are sold ex ante, before disease status is realized, while treatments are sold ex post. Even if the mean of the ex ante distribution of consumer values is the same as that ex post, the shape of the distributions may differ, generating a difference between the surplus each product can extract. If, for example, consumers differ only in ex ante disease risk, then a monopolist would have more difficulty extracting surplus with a preventive than with a treatment because treatment consumers, having contracted the disease, no longer differ in disease risk. We show that the ratio of preventive to treatment producer surplus can be arbitrarily small, in particular when the distribution of consumer values has a Zipf shape and the disease is rare. The firm’s bias toward treatments can be reversed, for example, if the source of private information is disease severity learned ex post. The difference between the producer surplus earned from the products can result in distorted R&D incentives; the deadweight loss from this distortion can be as large as the entire producer-surplus difference. Calibrations for HIV and heart attacks based on risk factors in the U.S. population suggest that the distribution of disease risk is sufficiently Zipf-similar to generate substantial differences between producer surplus from preventives and treatments. Empirically, we find that proxies for the Zipf-similarity of the disease-risk distribution are associated a significantly lower likelihood of vaccine development but not drug development. JEL Codes: O31, L11, I18, D42.

Suggested Citation

  • Michael Kremer & Christopher M. Snyder, 2015. "Preventives Versus Treatments," The Quarterly Journal of Economics, Oxford University Press, vol. 130(3), pages 1167-1239.
  • Handle: RePEc:oup:qjecon:v:130:y:2015:i:3:p:1167-1239.
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    File URL: http://hdl.handle.net/10.1093/qje/qjv012
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    Citations

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    Cited by:

    1. Eswaran, Mukesh & Gallini, Nancy, 2016. "Rescuing the Golden Age of Antibiotics: Can Economics Help Avert the Looming Crisis?," Economics working papers nancy_gallini-2016-9, Vancouver School of Economics, revised 04 Jul 2016.
    2. repec:eee:jetheo:v:177:y:2018:i:c:p:245-279 is not listed on IDEAS
    3. repec:kap:revind:v:53:y:2018:i:1:d:10.1007_s11151-018-9628-x is not listed on IDEAS
    4. Kjell Hausken & Mthuli Ncube, 2017. "Policy makers, the international community and the population in the prevention and treatment of diseases: case study on HIV/AIDS," Health Economics Review, Springer, vol. 7(1), pages 1-12, December.
    5. Eswaran, Mukesh & Gallini, Nancy, 2017. "Can Competition Extend the Golden Age of Antibiotics?," Microeconomics.ca working papers -2017-9, Vancouver School of Economics, revised 19 Oct 2017.
    6. Michael Kremer & Christopher M. Snyder, 2018. "Preventives Versus Treatments Redux: Tighter Bounds on Distortions in Innovation Incentives with an Application to the Global Demand for HIV Pharmaceuticals," Review of Industrial Organization, Springer;The Industrial Organization Society, vol. 53(1), pages 235-273, August.
    7. Hausken, Kjell & Ncube, Mthuli, 2015. "Policy-Makers, the International Community and People Living with HIV: The Need for New Commitment Mechanisms," UiS Working Papers in Economics and Finance 2015/6, University of Stavanger.

    More about this item

    JEL classification:

    • D42 - Microeconomics - - Market Structure, Pricing, and Design - - - Monopoly
    • I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health
    • L11 - Industrial Organization - - Market Structure, Firm Strategy, and Market Performance - - - Production, Pricing, and Market Structure; Size Distribution of Firms
    • O31 - Economic Development, Innovation, Technological Change, and Growth - - Innovation; Research and Development; Technological Change; Intellectual Property Rights - - - Innovation and Invention: Processes and Incentives

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