The Effect of Price Caps on Advertising to Physicians: Evidence from the 340b Drug Pricing Program
中文摘要
我们利用一项价格监管计划产生的药品折扣差异，研究了价格上限对制药企业提供高成本努力的影响，该计划允许符合条件的医院以大幅折扣购买门诊药品。这些折扣直接影响药品制造商的加价，并可能改变企业向这些医院医生投入促销努力的激励。我们发现，价格监管对制药企业努力的影响关键取决于监管设计以及制药企业的多产品性质。利用制药企业向医生营销支付的详细数据，我们观察到，在医生所在医院参与该计划后，其收到的促销支付减少了13%。价格上限的设计意味着折扣往往随药品上市年限的增加而增大。与理论预测一致，我们发现制药企业将促销支付从较老的药品转向受价格上限影响较小的较新药品。对于某些药品，这种转移导致尽管存在价格上限，对医生的支付仍然增加。理解这些战略性的非价格调整，对于寻求设计针对特定产品的有效监管的政策制定者而言十分重要。本文由营销领域编辑Jean-Pierre Dube接收。资助：本研究得到The Morrison Center for Marketing and Data Analytics和美国国家科学基金会[资助号SES-1919040]的支持。补充材料：在线附录和数据文件可在 https://doi.org/10.1287/mnsc.2024.05073 获取。
Abstract
We study the effect of price caps on the provision of costly effort by pharmaceutical firms using variation in drug discounts generated by a price regulation program that allows eligible hospitals to purchase outpatient drugs at steep discounts. These discounts directly affect drug manufacturers’ markups and may change firms’ incentives to exert promotional effort targeted toward physicians at these hospitals. We find that the effects of price regulation on pharmaceutical firm effort depend crucially on the design of the regulations and the multiproduct nature of pharmaceutical firms. Using detailed data on marketing payments from pharmaceutical firms to physicians, we observe that physicians receive 13% fewer promotional payments after their hospitals take up the program. The design of the price caps implies that discounts tend to increase with a drug’s age. Consistent with theoretical predictions, we find that pharmaceutical firms shift promotional payments away from older drugs and toward newer drugs, which are less affected by the price caps. For some drugs, this shift results in an increase in payments to physicians despite the price caps. Understanding these strategic, nonprice adjustments is important for policymakers seeking to design effective regulations targeting specific products. This paper was accepted by Jean-Pierre Dube, marketing. Funding: This work was supported by The Morrison Center for Marketing and Data Analytics and the National Science Foundation [Grant SES-1919040]. Supplemental Material: The online appendix and data files are available at https://doi.org/10.1287/mnsc.2024.05073 .