没有免费午餐？通过专家中介销售的企业福利分析

Review of Economic Studies · 2024 · [{"name": "Matthew Grennan", "affiliation": ["Berkeley College", "University of California, Berkeley"]}, {"name": "Kyle Myers", "affiliation": ["Dana-Farber/Harvard Cancer Center"]}, {"name": "Ashley Swanson", "affiliation": ["University of Wisconsin–Madison", "Madison Group (United States)"]}, {"name": "Aaron Chatterji", "affiliation": ["Duke University", "Fulda University of Applied Sciences"]}]

中文摘要

我们研究企业如何瞄准并影响专家中介。在本文情境中，制药厂商在促销互动中向医生提供支付。我们提出一种识别策略，利用因对AMC利益冲突政策溢出效应的暴露程度存在差异而产生的、可合理视为外生的支付变异。通过对一类重要心血管药物的案例研究，我们估计了支付对处方行为的异质性效应，发现企业瞄准的是反应高度敏感的医生。我们还构建了一个供需模型，据此量化寡头垄断价格如何减少药物处方，以及支付如何使处方更接近最优水平，但代价是巨大的财务成本。在我们估计的模型中，消费者是否因支付而受损，取决于是否存在由行为摩擦或其他摩擦导致的显著处方不足。在最后一项分析中，我们利用临床数据校准了这类摩擦，并估计在本案例研究中支付使消费者受益。

Abstract

Abstract We study how firms target and influence expert intermediaries. In our context, pharmaceutical manufacturers provide payments to physicians during promotional interactions. We develop an identification strategy based on plausibly exogenous variation in payments driven by differential exposure to spillovers from AMC CoI policies. Using a case study of an important class of cardiovascular drugs, we estimate heterogeneous effects of payments on prescribing, with firms targeting highly responsive physicians. We also develop a model of supply and demand, which allows us to quantify how oligopoly prices reduce drug prescribing, and how payments move prescribing closer to the optimal level, but at great financial cost. In our estimated model, whether consumers are harmed by payments depends on whether there is substantial under-prescribing due to behavioural or other frictions. In a final exercise, we calibrate such frictions using clinical data and estimate that payments benefit consumers in this case study.