削弱竞争对手：制药市场的纵向一体化
Disadvantaging Rivals: Vertical Integration in the Pharmaceutical Market
American Economic Journal: Applied Economics · 2025 · [{"name": "Charles Gray", "affiliation": ["The White House"]}, {"name": "Abby Alpert", "affiliation": ["University of Pennsylvania"]}, {"name": "Neeraj Sood", "affiliation": ["University of Southern California"]}]
中文摘要
近年来, 医药市场经历了药品福利管理机构 (PBM) 与保险公司之间的一波纵向一体化浪潮。基于一份关于保险公司-PBM合同的独特数据集, 我们记录了联邦医疗保险D部分 (Medicare Part D) 中纵向一体化程度的上升。随后, 我们评估了2015年一起大型保险公司-PBM合并的影响, 考察纵向一体化的权衡取舍——一方面损害竞争, 另一方面提升效率。我们发现, 合并后竞争对手保险公司的保费上升, 这与纵向一体化的PBM通过投入品封锁抬高成本相一致。我们未发现合并企业的消费者因保费下降而获益的证据。(JEL G22, G34, I13, I18, L22, L65)
Abstract
The pharmaceutical market has experienced a wave of vertical integration between pharmacy benefit managers (PBMs) and insurers in recent years. Using a unique dataset on insurer-PBM contracts, we document increasing vertical integration in Medicare Part D. Next, we evaluate the effects of a large insurer-PBM merger in 2015, assessing the trade-offs of vertical integration—harms to competition on the one hand and improved efficiency on the other. We find premium increases for rival insurers post-merger, consistent with vertically integrated PBMs raising costs through input foreclosure. We find no evidence of benefits to consumers of the merged firm from lower premiums. (JEL G22, G34, I13, I18, L22, L65)