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仿制药短缺的经济学: 竞争的局限

The Economics of Generic Drug Shortages: The Limits of Competition
Journal of Economic Perspectives · 2025 · [{"name": "Rena M. Conti", "affiliation": ["American Society of Law, Medicine and Ethics"]}, {"name": "Marta Wosińska", "affiliation": ["Brookings Institution"]}]

中文摘要

我们考察了美国仿制处方药市场的经济学问题,该市场占所售药品的大部分。该市场因为消费者带来高质量、低价格而备受赞誉,但也日益面临可能扰乱患者护理的短缺问题的挑战。仿制药市场的短缺提出了一个经济学谜题——面对短缺,价格本应上涨以鼓励企业进入,然而我们观察到短缺的数量和持续性都在增加。此外,如果短缺会损害患者,为何市场不为可靠的供应链支付溢价?我们认为,这一谜题可以由监管和合约摩擦导致仿制药价格难以轻易调整,以及美国市场中同时存在的信息不对称和代理问题来解释。最后,我们讨论了旨在应对这些挑战、确保美国仿制药供应具有韧性的政策干预措施。

Abstract

We examine the economics of the US generic prescription drug market, which comprises the majority of medicines sold. The market is celebrated for its benefits in the form of high quality and low prices for consumers but is also increasingly challenged by shortages that may disrupt patient care. Shortages in the generic drug market present an economic puzzle — in the face of a shortage, prices should rise, encouraging entry, yet we observe shortages increasing in number and persistence. Moreover, if shortages cause patient harm, why don’t markets pay a premium for a reliable supply chain? We argue that the puzzle can be explained by the inability of generic drug prices to adjust easily due to regulatory and contracting frictions, and the coexisting presence of asymmetric information and agency problems in the US market. We conclude with a discussion of policy interventions aimed at addressing these challenges to ensure resilient US generic drug supply.
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