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Pharmaceutical Pricing in Emerging Markets: Effects of Income, Competition and Procurement

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  • Patricia M. Danzon
  • Andrew W. Mulcahy
  • Adrian K. Towse

Abstract

This paper analyzes determinants of ex-manufacturer prices for originator and generic drugs across a large sample of countries. We focus on drugs to treat HIV/AIDS, TB and malaria in middle and low income countries (MLICs), with robustness checks to other therapeutic categories and other countries. We examine effects of per capita income, income dispersion, number and type of therapeutic and generic competitors, and whether the drugs are sold to retail pharmacies vs. tendered procurement by NGOs. The cross-national income elasticity of prices is 0.4 across high and low income countries, but is only 0.15 between MLICs, implying that drugs are least affordable relative to income in the lowest income countries. Within-country income inequality contributes to relatively high prices in MLICs. Number of therapeutic and generic competitors only weakly affects prices to retail pharmacies, plausibly because uncertain quality leads to competition on brand rather than price. Tendered procurement attracts multi-national generic suppliers and significantly reduces prices for originators and generics, compared to prices to retail pharmacies.

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  • Patricia M. Danzon & Andrew W. Mulcahy & Adrian K. Towse, 2011. "Pharmaceutical Pricing in Emerging Markets: Effects of Income, Competition and Procurement," NBER Working Papers 17174, National Bureau of Economic Research, Inc.
    • Handle: RePEc:nbr:nberwo:17174
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    Cited by:

    1. Patricia Danzon & Adrian Towse & Jorge Mestre‐Ferrandiz, 2015. "Value‐Based Differential Pricing: Efficient Prices for Drugs in a Global Context," Health Economics, John Wiley & Sons, Ltd., vol. 24(3), pages 294-301, March.
    2. Rajat Acharyya & María D. C. García-Alonso, 2014. "Universal Access, Parallel Trade And Incentives To Innovate," Bulletin of Economic Research, Wiley Blackwell, vol. 66(S1), pages 74-91, December.
    3. Dubois, Pierre & Lefouili, Yassine & Straub, Stéphane, 2021. "Pooled procurement of drugs in low and middle income countries," European Economic Review, Elsevier, vol. 132(C).
    4. Xiaojie Yang & Li Liu & Yi Zheng & Xue Yang & Shanlin Sun, 2022. "Pricing Problems in the Pharmaceutical Supply Chain with Mixed Channel: A Power Perspective," Sustainability, MDPI, vol. 14(12), pages 1-20, June.
    5. Patricia M. Danzon & Michael F. Furukawa, 2011. "Cross-National Evidence on Generic Pharmaceuticals: Pharmacy vs. Physician-Driven Markets," NBER Working Papers 17226, National Bureau of Economic Research, Inc.
    6. Lucy Xiaolu Wang, 2023. "A cost-benefit analysis of the medicines patent pool," Economics Bulletin, AccessEcon, vol. 43(3), pages 1298-1319.
    7. Shi, Wunan & Wouters, Olivier J. & Liu, Gordon & Mossialos, Elias & Yang, Xiuyun, 2020. "Association between provincial income levels and drug prices in China over the period 2010–2017," Social Science & Medicine, Elsevier, vol. 263(C).
    8. Weko, Silvia & Goldthau, Andreas, 2022. "Bridging the low-carbon technology gap? Assessing energy initiatives for the Global South," Energy Policy, Elsevier, vol. 169(C).
    9. Magno, Cielo & Guzman, Ricardo Rafael S., 2019. "Drug price sensitivity among physicians in a developing healthcare system: Evidence from the Philippine market for statins and beta blockers," Economic Analysis and Policy, Elsevier, vol. 62(C), pages 268-279.
    10. Wouters, Olivier J. & Sandberg, Dale M. & Pillay, Anban & Kanavos, Panos G., 2019. "The impact of pharmaceutical tendering on prices and market concentration in South Africa over a 14-year period," Social Science & Medicine, Elsevier, vol. 220(C), pages 362-370.
    11. Wouters, Olivier J. & Sandberg, Dale M. & Pillay, Anban & Kanavos, Panos, 2018. "The impact of pharmaceutical tendering on prices and market concentration in South Africa over a 14-year period," LSE Research Online Documents on Economics 90828, London School of Economics and Political Science, LSE Library.
    12. Chen, Xu & Yang, Huan & Wang, Xiaojun, 2019. "Effects of price cap regulation on the pharmaceutical supply chain," Journal of Business Research, Elsevier, vol. 97(C), pages 281-290.
    13. Callejas, Jerónimo & Mohapatra, Debi Prasad, 2021. "Welfare effects of public procurement of medicines: Evidence from Ecuador," International Journal of Industrial Organization, Elsevier, vol. 75(C).
    14. Anderson, Robert D. & Pelletier, Philippe & Osei-Lah, Kodjo & Müller, Anna Caroline, 2011. "Assessing the value of future accessions to the WTO Agreement on Gouvenement Procurement (GPA): Some new data sources, provisional estimates, and an evaluative framework for individual WTO members con," WTO Staff Working Papers ERSD-2011-15, World Trade Organization (WTO), Economic Research and Statistics Division.
    15. Dai, Rong & Watal, Jayashree, 2021. "Product patents and access to innovative medicines," Social Science & Medicine, Elsevier, vol. 291(C).
    16. Srivastava, Divya & McGuire, Alistair, 2014. "Analysis of prices paid by low-income countries: how price sensitive is government demand for medicines?," LSE Research Online Documents on Economics 60341, London School of Economics and Political Science, LSE Library.
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    More about this item

    JEL classification:

    • I11 - Health, Education, and Welfare - - Health - - - Analysis of Health Care Markets
    • L11 - Industrial Organization - - Market Structure, Firm Strategy, and Market Performance - - - Production, Pricing, and Market Structure; Size Distribution of Firms
    • O14 - Economic Development, Innovation, Technological Change, and Growth - - Economic Development - - - Industrialization; Manufacturing and Service Industries; Choice of Technology
    • O25 - Economic Development, Innovation, Technological Change, and Growth - - Development Planning and Policy - - - Industrial Policy

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