The Prescription Drug Market

This chapter describes how prescription drug markets deviate from “normal” competitive markets. On the demand side, there is considerable uncertainty in disease prognosis and treatment effects; buyers have much less information than sellers; consumers usually do not pay directly for their prescriptions but rather have health insurance, which protects them from a drug’s full price; and physicians and insurers play a major role in consumer choices. On the supply side, firms are heavily regulated, subject to laws requiring that drugs undergo extensive testing before entering the marketplace. Monopolies are a system feature, designed to incentivize companies to invest in expensive and risky drug discovery by providing the prospect of a big payoff if the investment succeeds. Patents and market exclusivity restrict competition and provide drug developers considerable pricing power. The challenge for policymakers is how to achieve reasonable or fair drug prices in light of these market distortions.

Technology transfer in prescription drug market

Purpose Many people in developing countries are suffering from serious diseases, such as HIV and tuberculosis. On the other hand, drug patents impact the availability of the drug for patients. Pharmaceutical technology transfer is widely used by domestic and foreign pharmaceutical enterprises because it promotes the availability of the drug for patients. The purpose of this paper, which is on drug technology transfer, is mainly to discuss how to solve the conflict between drug patent protection and public health from the perspective of the law, but not from the perspective of economics. To fill this gap, the authors introduce a model in the prescription drug market and analyze how a foreign manufacturer that produces brand name drugs authorizes a domestic enterprise that produces common drugs. Design/methodology/approach In this paper, the authors consider a situation that if the patent holders are provided a certain amount of compensation, then whether compulsory licensing would be an effective tool to promote competition and improve the availability of drugs. Furthermore, they also consider three different cooperation mechanisms, namely, fixed-fee contract, royalty contract and two-part tariff contract, under the case of technology transfer and give the condition of which contract would be better under different scenarios. Findings It is found that the product differentiation and the agent behavior of doctor in the domestic market have a deep impact on the foreign enterprise’s decision on technology transfer. If both fixed-fee contract and royalty contract are permitted, foreign enterprise will choose different transfer contracts under different conditions. Under two-part tariff contract, it is equivalent to a fixed-fee or royalty contract under certain conditions. Furthermore, all contracts can improve patients’ benefits, while the royalty contract and the two-part tariff contract would reduce importer’s social welfare under certain conditions. Originality/value Prescription drugs can treat many acute diseases and improve people’s quality of life. On the other hand, it requires investment in pharmaceutical research and development and is hard to afford the drug for the people living in poverty. This paper tries to solve the problem by introducing three cooperation contracts. The authors consider an innovative drug company and a regular drug company. The regular drug company can improve the quality of its drug by signing a technology transfer agreement with the innovative company. Three contracts are discussed in this paper; they are fixed-fee contract, royalty contract and two-part tariff contract. The authors examine the impact of different contracts on the companies’ profit, patients’ benefit and social welfare. It is found that quality differentiation of drugs and doctor behaviors can have large impacts on the company’s decision about technology adoption as well as contract choice strategies. In all of the three contracts, patients’ benefit improves, while the profit of the two companies and social welfare can increase or decrease under different contracts.

It’s the Same, Only It’s Not: Perceptions of the Prescription Drug Market in Comparison With Other Illicit Drug Markets

Given the rapid rise of prescription (Rx) opioid overdoses in the United States, it is crucial to understand how people acquire Rx drugs. Prior research suggests individuals obtain Rx drugs through both legal and illegal channels, but there has been limited qualitative research focused upon the intersections between Rx drug markets and other drug markets. To understand the similarities and differences, we interviewed 40 incarcerated women about their experiences with both markets. Based upon these conversations, we find that few women received pills exclusively through doctors and 90% of them had used illicit markets or informal social networks to acquire Rx drugs. Although there is extensive overlap between the users, dealers, and operations between Rx and illicit drug markets, these women draw attention to how certain agents, processes, and social reactions differ in meaningful ways that are crucial to an effective public health response.