Intended and Unintended Consequences of Drug Price Regulations

2018 ◽  
Author(s):  
Jun Li ◽  
Di Wu

2021 ◽  
Author(s):  
Jun Li ◽  
Di (Andrew) Wu

Policy makers in many developing countries use maximum price or markup policies to control pharmaceutical costs, which represent 20%–60% of their overall healthcare expenditure. We study the price effect of price ceiling policies by exploiting a major policy shift in China: the elimination of longstanding ceilings on retail drug prices. We collect weekly price and characteristics data on more than 4,500 drug stock keeping units (SKUs) from a leading pharmacy chain. By comparing the rate of discontinuous price jumps across drugs with and without price ceilings during the years before and after the policy change, we find that while price ceilings are effective in containing the prices of some drugs, they can lead to higher prices for others, particularly if the ceilings are set at the national level irrespective of local economic conditions. About 5% of nationally controlled drugs (or more than 125 drugs) had inflated prices because of price ceilings, with an average price inflation of 10%. We attribute this perverse price effect to focal point pricing and asymmetric information about production costs. Further supporting this view, we find the perverse price effect most prominent in lower-income regions where the centrally set price ceilings are arbitrarily high considering their poorer economic conditions. Moreover, drugs with highly concentrated production and less elastic demand face heightened risks of inflated prices under price ceilings. Finally, based on a sample of drugs with available price ceiling data, we find that drugs with manufacturer-specific ceilings are 100% more likely to be priced at or near their ceilings and 70% more likely to experience price drops once the ceilings are removed compared with other drugs with regular ceilings. Overall, this paper documents the unintended perverse effect of price ceilings in pharmaceutical markets and sheds lights on the ongoing debate of drug price regulation. This paper was accepted by Stefan Scholtes, healthcare management.







2007 ◽  
Author(s):  
Evan P. Apfelbaum ◽  
Samuel R. Sommers ◽  
Michael I. Norton


2020 ◽  
Vol 91 (8) ◽  
pp. 651-661
Author(s):  
Joshua T. Davis ◽  
Hilary A. Uyhelji

INTRODUCTION: Although the impact of microorganisms on their hosts has been investigated for decades, recent technological advances have permitted high-throughput studies of the collective microbial genomes colonizing a host or habitat, also known as the microbiome. This literature review presents an overview of microbiome research, with an emphasis on topics that have the potential for future applications to aviation safety. In humans, research is beginning to suggest relationships of the microbiome with physical disorders, including type 1 and type 2 diabetes mellitus, cardiovascular disease, and respiratory disease. The microbiome also has been associated with psychological health, including depression, anxiety, and the social complications that arise in autism spectrum disorders. Pharmaceuticals can alter microbiome diversity, and may lead to unintended consequences both short and long-term. As research strengthens understanding of the connections between the microbiota and human health, several potential applications for aerospace medicine and aviation safety emerge. For example, information derived from tests of the microbiota has potential future relevance for medical certification of pilots, accident investigation, and evaluation of fitness for duty in aerospace operations. Moreover, air travel may impact the microbiome of passengers and crew, including potential impacts on the spread of disease nationally and internationally. Construction, maintenance, and cleaning regimens that consider the potential for microbial colonization in airports and cabin environments may promote the health of travelers. Altogether, the mounting knowledge of microbiome effects on health presents several opportunities for future research into how and whether microbiome-based insights could be used to improve aviation safety.Davis JT, Uyhelji HA. Aviation and the microbiome. Aerosp Med Hum Perform. 2020; 91(8):651–661.



2016 ◽  
Vol 2 (1) ◽  
pp. 51-69 ◽  
Author(s):  
Setsuko Matsuzawa

This article explores the relations between a foreign aid donor and local actors in the context of the dissemination of development discourses and practices in an authoritarian context. It addresses the question “To what extent may the local dynamics alter the original goals of a donor and lead to unintended consequences?” Based on archival research, interviews, and secondary literature, this case study examines the Yunnan Uplands Management Project (YUM) in 1990–95, the Ford Foundation's first grant program on rural poverty alleviation in China. While the Foundation did not attain its main goal of making YUM a national model for poverty alleviation, the local actors were able to use YUM to develop individual capacities and to build roles for themselves as development actors in the form of associations and nongovernmental organizations, resulting in further support from the Foundation. The study contributes to our understanding of donor-local actor dynamics by highlighting the gaps between the original goals of a donor and the perspectives and motivations of local actors. The study suggests that local dynamics may influence the goals of donors and the ways they seek to disseminate development discourses and practices to local actors, despite the common conception of donors as hegemonic or culturally imperialistic.



2019 ◽  
Vol 103 (1) ◽  
pp. 33-35 ◽  
Author(s):  
Don Flaten ◽  
Andrew Sharpley ◽  
Helen Jarvie ◽  
Peter Kleinman

This article reflects upon the challenges we face in agricultural P management and provides a discussion about opportunities to promote more comprehensive and sustainable management of this valuable resource.



Author(s):  
Heather L. Welch ◽  
Christopher T. Green ◽  
Richard A. Rebich ◽  
Jeannie R.B. Barlow ◽  
Matthew B. Hicks


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