IDEAS home Printed from https://ideas.repec.org/p/nbr/nberwo/30779.html
   My bibliography  Save this paper

The Economics of the Public Option: Evidence from Local Pharmaceutical Markets

Author

Listed:
  • Juan Pablo Atal
  • José Ignacio Cuesta
  • Felipe González
  • Cristóbal Otero

Abstract

We study the effects of competition by state-owned firms, leveraging the decentralized entry of public pharmacies to local markets in Chile. Public pharmacies sell the same drugs at a third of private pharmacy prices, because of stronger upstream bargaining and market power in the private sector, but are of lower quality. Public pharmacies induced market segmentation and price increases in the private sector, which benefited the switchers to the public option but harmed the stayers. The countrywide entry of public pharmacies would reduce yearly consumer drug expenditure by 1.5 percent.

Suggested Citation

  • Juan Pablo Atal & José Ignacio Cuesta & Felipe González & Cristóbal Otero, 2022. "The Economics of the Public Option: Evidence from Local Pharmaceutical Markets," NBER Working Papers 30779, National Bureau of Economic Research, Inc.
  • Handle: RePEc:nbr:nberwo:30779
    Note: EH IO PE POL
    as

    Download full text from publisher

    File URL: http://www.nber.org/papers/w30779.pdf
    Download Restriction: no
    ---><---

    Other versions of this item:

    References listed on IDEAS

    as
    1. Andrei Shleifer, 1998. "State versus Private Ownership," Journal of Economic Perspectives, American Economic Association, vol. 12(4), pages 133-150, Fall.
    2. Matias Busso & Sebastian Galiani, 2019. "The Causal Effect of Competition on Prices and Quality: Evidence from a Field Experiment," American Economic Journal: Applied Economics, American Economic Association, vol. 11(1), pages 33-56, January.
    3. Zi Yang Kang & Shoshana Vasserman, 2022. "Robustness Measures for Welfare Analysis," NBER Working Papers 29656, National Bureau of Economic Research, Inc.
    4. Atal, Juan Pablo & Cuesta, José Ignacio & Sæthre, Morten, 2018. "Quality Regulation and Competition: Evidence from Pharmaceutical Markets," Discussion Paper Series in Economics 20/2018, Norwegian School of Economics, Department of Economics.
    5. Ernesto Dal Bó & Pedro Dal Bó & Erik Eyster, 2018. "The Demand for Bad Policy when Voters Underappreciate Equilibrium Effects," The Review of Economic Studies, Review of Economic Studies Ltd, vol. 85(2), pages 964-998.
    6. Daniel Bennett & Wesley Yin, 2019. "The Market for High-Quality Medicine: Retail Chain Entry and Drug Quality in India," The Review of Economics and Statistics, MIT Press, vol. 101(1), pages 76-90, March.
    7. González, Felipe & Prem, Mounu, 2018. "Can television bring down a dictator? Evidence from Chile’s “No” campaign," Journal of Comparative Economics, Elsevier, vol. 46(1), pages 349-361.
    8. Gautam Gowrisankaran & Aviv Nevo & Robert Town, 2015. "Mergers When Prices Are Negotiated: Evidence from the Hospital Industry," American Economic Review, American Economic Association, vol. 105(1), pages 172-203, January.
    9. Dubois, Pierre & Lefouili, Yassine & Straub, Stéphane, 2021. "Pooled procurement of drugs in low and middle income countries," European Economic Review, Elsevier, vol. 132(C).
    10. Vittorio Bassi & Imran Rasul, 2017. "Persuasion: A Case Study of Papal Influences on Fertility-Related Beliefs and Behavior," American Economic Journal: Applied Economics, American Economic Association, vol. 9(4), pages 250-302, October.
    11. Di Tella, Rafael & Galiani, Sebastian & Schargrodsky, Ernesto, 2021. "Persuasive propaganda during the 2015 Argentine Ballotage," Journal of Comparative Economics, Elsevier, vol. 49(4), pages 885-900.
    12. John A. List & Daniel M. Sturm, 2006. "How Elections Matter: Theory and Evidence from Environmental Policy," The Quarterly Journal of Economics, President and Fellows of Harvard College, vol. 121(4), pages 1249-1281.
    13. Gerber, Alan S. & Gimpel, James G. & Green, Donald P. & Shaw, Daron R., 2011. "How Large and Long-lasting Are the Persuasive Effects of Televised Campaign Ads? Results from a Randomized Field Experiment," American Political Science Review, Cambridge University Press, vol. 105(1), pages 135-150, February.
    14. Brian Adams & Kevin R. Williams, 2019. "Zone Pricing in Retail Oligopoly," American Economic Journal: Microeconomics, American Economic Association, vol. 11(1), pages 124-156, February.
    15. Marco Manacorda & Edward Miguel & Andrea Vigorito, 2011. "Government Transfers and Political Support," American Economic Journal: Applied Economics, American Economic Association, vol. 3(3), pages 1-28, July.
    16. Cremer, Helmuth & Marchand, Maurice & Thisse, Jacques-Francois, 1991. "Mixed oligopoly with differentiated products," International Journal of Industrial Organization, Elsevier, vol. 9(1), pages 43-53, March.
    17. Christopher Timmins, 2002. "Measuring the Dynamic Efficiency Costs of Regulators' Preferences: Municipal Water Utilities in the Arid West," Econometrica, Econometric Society, vol. 70(2), pages 603-629, March.
    18. Gregory J. Martin & Ali Yurukoglu, 2017. "Bias in Cable News: Persuasion and Polarization," American Economic Review, American Economic Association, vol. 107(9), pages 2565-2599, September.
    19. William C. Merrill & Norman Schneider, 1966. "Government Firms in Oligopoly Industries: A Short-Run Analysis," The Quarterly Journal of Economics, President and Fellows of Harvard College, vol. 80(3), pages 400-412.
    20. Julia Fonseca & Adrien Matray, 2022. "Financial Inclusion, Economic Development, and Inequality: Evidence from Brazil," Working Papers 308, Princeton University, Department of Economics, Center for Economic Policy Studies..
    21. Ruben Enikolopov & Maria Petrova & Ekaterina Zhuravskaya, 2011. "Media and Political Persuasion: Evidence from Russia," American Economic Review, American Economic Association, vol. 101(7), pages 3253-3285, December.
    22. Pierre Dubois & Ashvin Gandhi & Shoshana Vasserman, 2022. "Bargaining and International Reference Pricing in the Pharmaceutical Industry," NBER Working Papers 30053, National Bureau of Economic Research, Inc.
    23. Alan S. Gerber & Dean Karlan & Daniel Bergan, 2009. "Does the Media Matter? A Field Experiment Measuring the Effect of Newspapers on Voting Behavior and Political Opinions," American Economic Journal: Applied Economics, American Economic Association, vol. 1(2), pages 35-52, April.
    24. David S. Lee, 2009. "Training, Wages, and Sample Selection: Estimating Sharp Bounds on Treatment Effects," The Review of Economic Studies, Review of Economic Studies Ltd, vol. 76(3), pages 1071-1102.
    25. David Atkin & Benjamin Faber & Marco Gonzalez-Navarro, 2018. "Retail Globalization and Household Welfare: Evidence from Mexico," Journal of Political Economy, University of Chicago Press, vol. 126(1), pages 1-73.
    26. Pierre Dubois & Laura Lasio, 2018. "Identifying Industry Margins with Price Constraints: Structural Estimation on Pharmaceuticals," American Economic Review, American Economic Association, vol. 108(12), pages 3685-3724, December.
    27. Jessie Handbury & Sarah Moshary, 2021. "School Food Policy Affects Everyone: Retail Responses to the National School Lunch Program," NBER Working Papers 29384, National Bureau of Economic Research, Inc.
    28. Stefano DellaVigna & Matthew Gentzkow, 2010. "Persuasion: Empirical Evidence," Annual Review of Economics, Annual Reviews, vol. 2(1), pages 643-669, September.
    29. Abhijit Banerjee & Rema Hanna & Jordan Kyle & Benjamin A. Olken & Sudarno Sumarto, 2019. "Private Outsourcing and Competition: Subsidized Food Distribution in Indonesia," Journal of Political Economy, University of Chicago Press, vol. 127(1), pages 101-137.
    30. Chad Kendall & Tommaso Nannicini & Francesco Trebbi, 2015. "How Do Voters Respond to Information? Evidence from a Randomized Campaign," American Economic Review, American Economic Association, vol. 105(1), pages 322-353, January.
    31. Richard G. Frank & David S. Salkever, 1997. "Generic Entry and the Pricing of Pharmaceuticals," Journal of Economics & Management Strategy, Wiley Blackwell, vol. 6(1), pages 75-90, March.
    32. Claudio Ferraz & Frederico Finan, 2008. "Exposing Corrupt Politicians: The Effects of Brazil's Publicly Released Audits on Electoral Outcomes," The Quarterly Journal of Economics, President and Fellows of Harvard College, vol. 123(2), pages 703-745.
    33. Baicker, Katherine & Finkelstein, Amy, 2019. "The Impact of Medicaid Expansion on Voter Participation: Evidence from the Oregon Health Insurance Experiment," Quarterly Journal of Political Science, now publishers, vol. 14(4), pages 383-400, October.
    34. Stefano DellaVigna & Ethan Kaplan, 2007. "The Fox News Effect: Media Bias and Voting," The Quarterly Journal of Economics, President and Fellows of Harvard College, vol. 122(3), pages 1187-1234.
    35. Basker, Emek, 2011. "The Causes and Consequences of Wal-Mart’s Growth," Ekonomicheskaya Politika / Economic Policy, Russian Presidential Academy of National Economy and Public Administration, vol. 5, pages 110-134.
    36. Julien Lafortune & Jesse Rothstein & Diane Whitmore Schanzenbach, 2018. "School Finance Reform and the Distribution of Student Achievement," American Economic Journal: Applied Economics, American Economic Association, vol. 10(2), pages 1-26, April.
    37. Michael Dinerstein & Troy D. Smith, 2021. "Quantifying the Supply Response of Private Schools to Public Policies," American Economic Review, American Economic Association, vol. 111(10), pages 3376-3417, October.
    38. Michael B. Ward & Jay P. Shimshack & Jeffrey M. Perloff & J. Michael Harris, 2002. "Effects of the Private-Label Invasion in Food Industries," American Journal of Agricultural Economics, Agricultural and Applied Economics Association, vol. 84(4), pages 961-973.
    39. Andrei Shleifer & Robert W. Vishny, 1994. "Politicians and Firms," The Quarterly Journal of Economics, President and Fellows of Harvard College, vol. 109(4), pages 995-1025.
    40. Peter Arcidiacono & Paul B. Ellickson & Carl F. Mela & John D. Singleton, 2020. "The Competitive Effects of Entry: Evidence from Supercenter Expansion," American Economic Journal: Applied Economics, American Economic Association, vol. 12(3), pages 175-206, July.
    41. Dubois, Pierre & Lasio, Laura, 2014. "Identifying Industry Margins with Unobserved Price Constraints: Structural Estimation on Pharmaceuticals," IDEI Working Papers 823, Institut d'Économie Industrielle (IDEI), Toulouse.
    42. Timothy J. Layton & Nicole Maestas & Daniel Prinz & Boris Vabson, 2019. "Private vs. Public Provision of Social Insurance: Evidence from Medicaid," NBER Working Papers 26042, National Bureau of Economic Research, Inc.
    43. de Fraja, Giovanni & Delbono, Flavio, 1989. "Alternative Strategies of a Public Enterprise in Oligopoly," Oxford Economic Papers, Oxford University Press, vol. 41(2), pages 302-311, April.
    44. Epple, Dennis & Romano, Richard E, 1998. "Competition between Private and Public Schools, Vouchers, and Peer-Group Effects," American Economic Review, American Economic Association, vol. 88(1), pages 33-62, March.
    45. Mark Bagnoli & Ted Bergstrom, 2006. "Log-concave probability and its applications," Studies in Economic Theory, in: Charalambos D. Aliprantis & Rosa L. Matzkin & Daniel L. McFadden & James C. Moore & Nicholas C. Yann (ed.), Rationality and Equilibrium, pages 217-241, Springer.
    46. Nicola Persico & Alessandro Lizzeri, 2001. "The Provision of Public Goods under Alternative Electoral Incentives," American Economic Review, American Economic Association, vol. 91(1), pages 225-239, March.
    47. Caroline M. Hoxby, 2000. "Does Competition among Public Schools Benefit Students and Taxpayers?," American Economic Review, American Economic Association, vol. 90(5), pages 1209-1238, December.
    48. Timothy Besley & Anne Case, 1995. "Does Electoral Accountability Affect Economic Policy Choices? Evidence from Gubernatorial Term Limits," The Quarterly Journal of Economics, President and Fellows of Harvard College, vol. 110(3), pages 769-798.
    49. Henrik Jacobsen Kleven & Wojciech Kopczuk, 2011. "Transfer Program Complexity and the Take-Up of Social Benefits," American Economic Journal: Economic Policy, American Economic Association, vol. 3(1), pages 54-90, February.
    50. Christopher Neilson & Michael Dinerstein & Sebastián Otero, 2020. "The Equilibrium Effects of Public Provision in Education Markets: Evidence from a Public School Expansion Policy," Working Papers 645, Princeton University, Department of Economics, Industrial Relations Section..
    51. Robin S. Lee & Michael D. Whinston & Ali Yurukoglu, 2021. "Structural Empirical Analysis of Contracting in Vertical Markets," NBER Working Papers 29282, National Bureau of Economic Research, Inc.
    52. Jerry Hausman & Ephraim Leibtag, 2007. "Consumer benefits from increased competition in shopping outlets: Measuring the effect of Wal-Mart," Journal of Applied Econometrics, John Wiley & Sons, Ltd., vol. 22(7), pages 1157-1177.
    53. Vilsa Curto & Liran Einav & Amy Finkelstein & Jonathan Levin & Jay Bhattacharya, 2019. "Health Care Spending and Utilization in Public and Private Medicare," American Economic Journal: Applied Economics, American Economic Association, vol. 11(2), pages 302-332, April.
    54. Doruk Cengiz & Arindrajit Dube & Attila Lindner & Ben Zipperer, 2019. "The Effect of Minimum Wages on Low-Wage Jobs," The Quarterly Journal of Economics, President and Fellows of Harvard College, vol. 134(3), pages 1405-1454.
    55. Lauren Falcao Bergquist & Michael Dinerstein, 2020. "Competition and Entry in Agricultural Markets: Experimental Evidence from Kenya," American Economic Review, American Economic Association, vol. 110(12), pages 3705-3747, December.
    56. David A. Matsa, 2011. "Competition and Product Quality in the Supermarket Industry," The Quarterly Journal of Economics, President and Fellows of Harvard College, vol. 126(3), pages 1539-1591.
    57. Mark Duggan & Fiona M. Scott Morton, 2006. "The Distortionary Effects of Government Procurement: Evidence from Medicaid Prescription Drug Purchasing," The Quarterly Journal of Economics, President and Fellows of Harvard College, vol. 121(1), pages 1-30.
    58. Ana Moura & Pedro Pita Barros, 2020. "Entry and price competition in the over‐the‐counter drug market after deregulation: Evidence from Portugal," Health Economics, John Wiley & Sons, Ltd., vol. 29(8), pages 865-877, August.
    59. Stefano DellaVigna & Matthew Gentzkow, 2019. "Uniform Pricing in U.S. Retail Chains," The Quarterly Journal of Economics, President and Fellows of Harvard College, vol. 134(4), pages 2011-2084.
    60. Guglielmo Barone & Francesco D'Acunto & Gaia Narciso, 2015. "Telecracy: Testing for Channels of Persuasion," American Economic Journal: Economic Policy, American Economic Association, vol. 7(2), pages 30-60, May.
    61. Diego Jimenez-Hernandez & Enrique Seira, 2022. "Should the government sell you goods? Evidence from the milk market in Mexico," Working Paper Series WP 2023-19, Federal Reserve Bank of Chicago.
    62. Panle Jia, 2008. "What Happens When Wal-Mart Comes to Town: An Empirical Analysis of the Discount Retailing Industry," Econometrica, Econometric Society, vol. 76(6), pages 1263-1316, November.
    63. Clinton, Joshua D. & Sances, Michael W., 2018. "The Politics of Policy: The Initial Mass Political Effects of Medicaid Expansion in the States," American Political Science Review, Cambridge University Press, vol. 112(1), pages 167-185, February.
    64. Yongmin Chen & Michael H. Riordan, 2008. "Price‐increasing competition," RAND Journal of Economics, RAND Corporation, vol. 39(4), pages 1042-1058, December.
    Full references (including those not matched with items on IDEAS)

    Citations

    Citations are extracted by the CitEc Project, subscribe to its RSS feed for this item.
    as


    Cited by:

    1. Christopher Neilson & Michael Dinerstein & Sebastián Otero, 2020. "The Equilibrium Effects of Public Provision in Education Markets: Evidence from a Public School Expansion Policy," Working Papers 645, Princeton University, Department of Economics, Industrial Relations Section..

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Rebecca Cleary & Jean-Paul Chavas, 2022. "Strategic supermarket pricing of private labels and manufacturer brands," Empirical Economics, Springer, vol. 62(6), pages 2921-2950, June.
    2. Sarah Schneider-Strawczynski & Jérôme Valette, 2021. "Media Coverage of Immigration and the Polarization of Attitudes," PSE Working Papers halshs-03322229, HAL.
    3. Sung Jae Jun & Sokbae Lee, 2023. "Identifying the Effect of Persuasion," Journal of Political Economy, University of Chicago Press, vol. 131(8), pages 2032-2058.
    4. Thomas Fujiwara & Karsten Müller & Carlo Schwarz, 2024. "The Effect of Social Media on Elections: Evidence from The United States," Journal of the European Economic Association, European Economic Association, vol. 22(3), pages 1495-1539.
    5. repec:hal:journl:hal-03533356 is not listed on IDEAS
    6. Matias Busso & Sebastian Galiani, 2019. "The Causal Effect of Competition on Prices and Quality: Evidence from a Field Experiment," American Economic Journal: Applied Economics, American Economic Association, vol. 11(1), pages 33-56, January.
    7. Magnus Carlsson & Gordon B. Dahl & Dan-Olof Rooth, 2015. "Backlash in Policy Attitudes After the Election of Extreme Political Parties," NBER Working Papers 21062, National Bureau of Economic Research, Inc.
    8. Harry Pickard, 2019. "A mailshot in the dark? The impact of the UK government's lea fet on the 2016 EU referendum," Working Papers 2019004, The University of Sheffield, Department of Economics.
    9. Talamas Marcos, Miguel Ángel, 2023. "Surviving Competition: Neighborhood Shops vs. Convenience Chains," IDB Publications (Working Papers) 13018, Inter-American Development Bank.
    10. Thomas Fujiwara & Karsten Müller & Carlo Schwarz, 2021. "The Effect of Social Media on Elections: Evidence from the United States," NBER Working Papers 28849, National Bureau of Economic Research, Inc.
    11. Mastrorocco, Nicola & Minale, Luigi, 2018. "News media and crime perceptions: Evidence from a natural experiment," Journal of Public Economics, Elsevier, vol. 165(C), pages 230-255.
    12. Carlsson, Magnus & Dahl, Gordon B. & Rooth, Dan-Olof, 2016. "Do Politicians Change Public Attitudes?," IZA Discussion Papers 10349, Institute of Labor Economics (IZA).
    13. Redlicki, B., 2017. "Spreading Lies," Cambridge Working Papers in Economics 1747, Faculty of Economics, University of Cambridge.
    14. Barrera, Oscar & Guriev, Sergei & Henry, Emeric & Zhuravskaya, Ekaterina, 2020. "Facts, alternative facts, and fact checking in times of post-truth politics," Journal of Public Economics, Elsevier, vol. 182(C).
    15. Jetter, Michael & Molina, Teresa, 2022. "Persuasive agenda-setting: Rodrigo Duterte’s inauguration speech and drugs in the Philippines," Journal of Development Economics, Elsevier, vol. 156(C).
    16. Michael Jetter, 2017. "Mediated Terrorism: US News and Al-Qaeda Attacks," CESifo Working Paper Series 6804, CESifo.
    17. Caroline Le Pennec & Vincent Pons, 2023. "How do Campaigns Shape Vote Choice? Multicountry Evidence from 62 Elections and 56 TV Debates," The Quarterly Journal of Economics, President and Fellows of Harvard College, vol. 138(2), pages 703-767.
    18. Jetter, Michael, 2019. "The inadvertent consequences of al-Qaeda news coverage," European Economic Review, Elsevier, vol. 119(C), pages 391-410.
    19. Alexsandros Cavgias & Raphael Corbi, Luis Meloni, Lucas M. Novaes, 2019. "EDITED DEMOCRACY: Media Manipulation and the News Coverage of Presidential Debates," Working Papers, Department of Economics 2019_17, University of São Paulo (FEA-USP).
    20. Sekou Keita & Thomas Renault & Jérôme Valette, 2024. "The Usual Suspects: Offender Origin, Media Reporting and Natives’ Attitudes Towards Immigration," The Economic Journal, Royal Economic Society, vol. 134(657), pages 322-362.
    21. Ashani Amarasinghe & Paul A. Raschky, 2022. "Competing for Attention - The Effect of Talk Radio on Elections and Political Polarization in the US," SoDa Laboratories Working Paper Series 2022-02, Monash University, SoDa Laboratories.

    More about this item

    JEL classification:

    • D72 - Microeconomics - - Analysis of Collective Decision-Making - - - Political Processes: Rent-seeking, Lobbying, Elections, Legislatures, and Voting Behavior
    • H4 - Public Economics - - Publicly Provided Goods
    • I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health
    • L3 - Industrial Organization - - Nonprofit Organizations and Public Enterprise

    NEP fields

    This paper has been announced in the following NEP Reports:

    Statistics

    Access and download statistics

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:nbr:nberwo:30779. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: the person in charge (email available below). General contact details of provider: https://edirc.repec.org/data/nberrus.html .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.