My dissertation explores the interactions between the various agents in the pharmaceutical industry and how they are affected by changes in health care policy. In my work, I examine innovation and competition among new brand drugs and the value of prescription drug insurance after patent expiration.
The second chapter of my dissertation empirically assesses the trade-off between patent breadth and patent length, a topic that has attracted significant theoretical but little empirical attention. I estimate a model of pharmaceutical demand and supply that incorporates insurance and advertising for the antidepressant market. Using these estimates, I consider the potential welfare effects of giving some of the most important product innovations broader but shorter patents, which increases the market power that these innovators have in the short-run but also allows for more rapid entry by generics. My results indicate that in this setting broader patents could increase total welfare by more than 9%, mostly through savings in insurer expenditures. These results are robust to endogenizing the entry of other branded drugs.
In the third chapter, which stems from research done jointly with Peter Arcidiacono, Paul Ellickson, and David Ridley, I use data from the pharmaceutical industry to estimate demand and supply for prescription drugs across both insured and uninsured consumers, allowing for consumer preferences organized into discrete types. I account for an important characteristic of health care markets: the price paid by insured consumers (copayment) is typically much smaller than the price received by the manufacturer. This analysis highlights how generic-drug availability differentially affects insured and uninsured consumers. In particular, generic entry disproportionately benefits insured consumers, at least in the first year to two years.
The fourth chapter in my dissertation extends the analysis in Chapter 2 to allow for a more generalized framework. In Chapter 2, the first pharmaceutical product innovation that enters a therapeutic class is assumed to be high-value while those innovations that follow are assumed to provide relatively little, if any, added therapeutic value beyond the first. Using the same data and demand model estimates, I consider the potential welfare effects of allowing these later to be considered high-value products and providing them with greater patent breadth and shorter patent length. My results indicate that in this setting, the modified patent policy could still increase total welfare by more than 8%, mostly through savings in insurer expenditures. These results are also robust to endogenizing the entry of other branded products.
