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Innovation in Healthcare Markets

Paper Session

Sunday, Jan. 5, 2020 8:00 AM - 10:00 AM (PDT)

Manchester Grand Hyatt, Solana Beach AB
Hosted By: Health Economics Research Organization
  • Chair: M. Kate Bundorf, Stanford University

ACA-Era Medicaid Expansions and Pharmaceutical Innovation

Ariel Stern
,
Harvard University
Craig Garthwaite
,
Northwestern University
Rebecca Sachs
,
Harvard University

Abstract

Prior research has documented a causal relationship between changes in pharmaceutical market size and new product R&D and introduction. In this paper, we investigate whether recent large-scale expansions in state Medicaid programs increased investments in the development of pharmaceuticals utilized by the Medicaid-eligible population. While prior studies have focused on the passage of Medicare Part D and demographic shifts in burden of disease as exogenous demand shifters, we focus on the impact of the Affordable Care Act (ACA)-era Medicaid expansions.

Over the period of our study, Medicaid enrollment grew by over 15 million across the United States. This led to an increase in the number of individuals with health insurance – and in particular, prescription drug benefits. However, Medicaid is known for relatively low rates of reimbursement for both services and medications. Although Medicaid expansions were expected to lead to an increase in the volume of prescription drugs covered, marginal revenues on this added volume were also expected to be low.

We present evidence for how ACA-era Medicaid expansions shifted demand for pharmaceuticals. The first contribution of this study is to show that members of the newly-eligible Medicaid population differed significantly from the traditional Medicaid population in their demand for pharmaceuticals. This, in turn, suggests that estimates of changes in demand based on historical data from Medicaid claims is likely to be a poor approximation of realized changes in demand as a result of eligibility expansions.

We then use a novel dataset of clinical trials linked to ICD-9 codes at the sub-chapter level to ask whether the passage of the ACA spurred the development of new products – or additional indications for existing products – targeting diseases with a high market share of new Medicaid enrollees. Across a number of different specifications, we fail to find evidence that the 2010

The ACA Medicaid Rebate Rule Change: Impact on Pricing and Innovation

Luca Maini
,
University of North Carolina-Chapel Hill
Joshua Feng
,
University of Utah

Abstract

We study how Medicaid drug procurement rules affect private markets, leveraging new data and changes to rules implemented in the Affordable Care Act (ACA). Using a stylized model, we illustrate how the rules of the Medicaid Drug Rebate Program (MDRP) qualitatively distorts pricing and innovation outcomes. Consistent with previous literature, the model predicts that larger mandatory rebates cause firms to set higher initial list prices. However, after factoring in the MDRP's inflation penalty and “best price” provisions, the model predicts that higher Medicaid rebates reduce list price growth, increase private market rebates, and can even encourage higher quality line extensions. We test these predictions using a difference-in-difference analysis that exploits an increase in the minimum Medicaid rebate implemented as part of the ACA. Our empirical results are consistent with the predictions of the model and provide a more nuanced view of the impact of mandatory rebate size on private drug market outcomes.

Medical Progress and Health Care Financing: Evidence from Academic Medical Centers

Pierre Azoulay
,
Massachusetts Institute of Technology
Jennifer Kao
,
University of California-Los Angeles
Misty Heggeness
,
U.S. Census Bureau

Abstract

Academic Medical Centers (AMCs)—comprising medical schools, teaching hospitals, and research laboratories—play an important role in the U.S. biomedical innovation system. We study the effect of changes in the generosity of clinical care reimbursements on the rate and direction of research performed within these institutions. The Balanced Budget Act of 1997 changed the formula used to reimburse Medicare inpatient claims and subsidies for medical residents. We compare AMCs’ relative exposure to the reform and how these differences affect their researchers’ ability to attract grant funding from public and industry sources, as well as the quantity, impact, and content of their publications. We find that in response to the BBA, research activity falls by 4% among the average teaching hospital and nearly 7% among major teaching hospitals, but the effects cut deeper into “translational” research activities. We find little evidence of concurrent changes in clinical outcomes.

Paving the Way for Cures? Valuing Failures in Drug Development

Joshua Krieger
,
Harvard University
Matthew Higgins
,
University of Utah
Danielle Li
,
Massachusetts Institute of Technology
Dimitris Papanikolaou
,
Northwestern University

Abstract

In this paper, we examine the value of exploration and exploitation in pharmaceuticals, taking into account the possibility that drug candidates can generate value by opening up new areas for research even if they themselves fail. We introduce new measures of drug candidate novelty and follow-on innovation based on how a candidate's own molecular structure relates to that of past or future candidates (whether successful or unsuccessful). We find follow-on drugs are more likely to be successful when they build on novel drugs, even when their predecessors failed in clinical trials. Despite this, derivative drugs make up both a high and increasing share of firm’s portfolios. We describe trends in the development of novel and follow-on drugs, and explore when firms capture value by building on their own (or competitors’) failed drug candidates.
Discussant(s)
Matthew Grennan
,
University of Pennsylvania
Wesley Yin
,
University of California-Los Angeles
JEL Classifications
  • I1 - Health
  • I0 - General