中文摘要
选择性合约是降低医疗成本日益流行的工具,但任何节省都必须与限制获取所带来的消费者剩余损失相权衡。近年来,许多处方药计划(PDP)利用优选药房网络来降低药品价格。我们的结果表明,采用优选药房网络的 Medicare Part D 计划支付的零售药品价格更低,而受补贴参保人对优选药房成本分担折扣的不敏感削弱了这些节省。随后我们估计药房需求模型以量化优选药房网络的成本与收益,发现由于在优选药房处自付(OOP)成本降低,平均参保人从优选药房合约中获益。
Abstract
Selective contracting is an increasingly popular tool for reducing health care costs, but any savings must be weighed against consumer surplus losses from restricted access. Recently, many prescription drug plans (PDPs) utilize preferred pharmacy networks to reduce drug prices. Our results suggest that Medicare Part D plans with preferred pharmacy networks pay lower retail drug prices, while subsidized enrollees’ insensitivity to preferred pharmacy cost-sharing discounts reduces these savings. We then estimate pharmacy demand models to quantify the costs and benefits of preferred pharmacy networks, finding that the average enrollee benefits from preferred pharmacy contracting due to reduced out-of-pocket (OOP) costs at preferred pharmacies.