Pharmaceutical competition within molecule markets post-patent expiry: Evidence from the USA, the UK, Germany and France 2000-2005.

摘要

In the interest of understanding the nature and degree of competition within off-patent molecule markets and improving purchasing efficiency, this thesis uses IMS Health data to analyse dimensions of competition within the off-patent omeprazole and paroxetine molecule markets in the USA, UK, France and Germany during the 2000q-2005ql period. The main theoretical findings include: Regulation in homogeneous markets may inhibit generic price competition. Generic manufacturers may also product differentiate, resulting in a Bertrand-like model of "softened" price competition. Other forms of product differentiation in off-patent molecule markets may include strength segments and the OTC market. The main empirical findings include: Generic price competition appears stronger in the USA and the UK than in Germany and France, although it is imperfect in all four countries. The USA and the UK achieve some of the lowest generic prices, while the UK is the most effective at actually purchasing its lowest prices. Generic penetration appears weak in less common strength segments, allowing original brand manufacturers' the opportunity to retain relatively large market shares. This results in higher purchased prices and, hence, significant purchasing inefficiencies. There appears to be competition between over-the-counter and prescription omeprazole in the USA, but not in the UK. OTC prices are relatively low in the US, offering the opportunity for cost savings. In the UK, patients may face a financial disincentive to purchase OTC omeprazole, possibly masking the opportunity for improved self-care. Certain countries may want to re-evaluate their generic reimbursement schemes in the interest of more price competitive markets and increased purchasing efficiency. Countries could also benefit from encouraging generic entry in less common strength markets. Finally, in approving an OTC switch, regulators should ensure that demand-side financial incentives are consistent with the goals of achieving cost containment and/or facilitating increased patient self-care.