Pharmaceuticals in U.S. health care: determinants of quantity and price.

The U.S. pharmaceutical industry has again become the focus of considerable controversy. In understanding the economics underlying this industry, distinctions between short, medium and long-run costs are critical, as is that between economic and accounting costs. Consumers' heterogeneous valuations create strong incentives for non-uniform pricing and targeted marketing. The conflict between static efficiency (price new drugs low, near short-run marginal cost) and dynamic efficiency (price new drugs high, maintain incentives for innovation) is deep and enduring. This trade-off is becoming more severe as the relative costs of bringing new drugs to market have increased sharply.

[1]  P. Nelson Advertising as Information , 1974, Journal of Political Economy.

[2]  R. Dorfman,et al.  Optimal Advertising and Optimal Quality , 1976 .

[3]  J. Newhouse Free for All?: Lessons from the RAND Health Insurance Experiment , 1993 .

[4]  P. Danzon,et al.  Price Discrimination for Pharmaceuticals: Welfare Effects in the US and the EU , 1997 .

[5]  The Distribution and Pricing of Prescription Drugs , 1997 .

[6]  J. Hellerstein,et al.  The importance of the physician in the generic versus trade-name prescription decision. , 1998, The Rand journal of economics.

[7]  W. S. Comanor,et al.  Strategic Pricing of New Pharmaceuticals , 1998, Review of Economics and Statistics.

[8]  E. Berndt,et al.  Comparing SSRI treatment costs for depression using retrospective claims data: the role of nonrandom selection and skewed data. , 2000, Value in health : the journal of the International Society for Pharmacoeconomics and Outcomes Research.

[9]  Michael Kremer,et al.  Creating Markets for New Vaccines. Part I: Rationale , 2000, Innovation Policy and the Economy.

[10]  Prescription Drugs: Continued Rapid Growth , 2000 .

[11]  E. Berndt,et al.  International comparisons of pharmaceutical prices: what do we know, and what does it mean? , 2000, Journal of health economics.

[12]  M. Kremer Creating Markets for New Vaccines. Part II: Design Issues , 2000, Innovation Policy and the Economy.

[13]  P. Danzon,et al.  Cross-national price differences for pharmaceuticals: how large, and why? , 2000, Journal of health economics.

[14]  Christopher M. Snyder,et al.  Countervailing Power in Wholesale Pharmaceuticals , 2001 .

[15]  E. Berndt The U.S. pharmaceutical industry: why major growth in times of cost containment? , 2001, Health affairs.

[16]  R. Frank Prescription drug prices: why do some pay more than others do? , 2001, Health affairs.

[17]  F. Scherer,et al.  The link between gross profitability and pharmaceutical R&D spending. , 2001, Health affairs.

[18]  D. Petitti Hormone replacement therapy for prevention: more evidence, more pessimism. , 2002, JAMA.

[19]  S. Normand,et al.  The Medical Treatment of Depression, 1991-1996: Productive Inefficiency, Expected Outcome Variations, and Price Indexes , 2000, Journal of health economics.

[20]  J. DiMasi,et al.  Returns on R&D for 1990s New Drug Introductions: Charts , 2003 .

[21]  E. Berndt,et al.  Promotion of prescription drugs to consumers. , 2002, The New England journal of medicine.

[22]  Elliott S Fisher,et al.  Geography and the debate over Medicare reform. , 2002, Health affairs.

[23]  M. Kyle,et al.  The Long Shadow of Patent Expiration , 2003 .

[24]  M. Kyle,et al.  The Long Shadow of Patent Expiration. Generic Entry and Rx-to-OTC Switches , 2003 .

[25]  E. Berndt,et al.  Demand Effects of Recent Changes in Prescription Drug Promotion , 2003 .