Do Pharmaceutical Prices Respond to Potential Patient Out-of-Pocket Expenses?
利用德国1989年一项政策实验，发现当患者自付费用与药品价格挂钩后，制药企业显著降价，尤其是品牌药和面临更多仿制药竞争的品牌药降价幅度更大。
Despite the importance of patient insurance in the market for prescription pharmaceuticals, little is known about the impact of patient reimbursement on the pricing behavior of pharmaceutical firms. I examine the link between potential patient out-of-pocket expenses and pharmaceutical pricing using a unique policy experiment from Germany. Starting in 1989, a maximum reimbursement for a given medicine replaced a flat prescription fee. This change in reimbursement exposes the patient to the price of a prescribed product. Using a product-level panel data set covering several therapeutic categories before and after the policy change, I find that producers significantly decrease prices after the change in potential patient out-of-pocket expenses. Price declines are most pronounced for brand-name products. Moreover, branded products that face more generic competitors reduce prices more.