Profiting from Most-Favored-Customer Procurement Rules: Evidence from Medicaid
研究发现2010年《平价医疗法案》提高医疗补助最低药品回扣，使非医疗补助药品支出下降2.5%，并估计取消最惠客户条款可再降3.5%，但可能增加医疗补助支出。
Using a difference-in-difference approach, we find that an increase to Medicaid’s minimum drug rebate under the Affordable Care Act in 2010 lowered non-Medicaid drug spending by 2.5 percent. A stylized bargaining model shows that this is likely driven by the interaction of this reform with Medicaid’s “most-favored customer” clause (MFCC). By examining the response of drugs that faced a change in incentives equivalent to the removal of Medicaid’s MFCC, we estimate that removing the Medicaid MFCC would have reduced overall 2010 non-Medicaid drug spending by an additional 3.5 percent, though it would have likely also increased Medicaid spending.