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Understanding manufacturer-sponsored copay assistance programs for pharmaceuticals / Molly Frean.
- Format:
- Book
- Thesis/Dissertation
- Author/Creator:
- Frean, Molly, author.
- Language:
- English
- Subjects (All):
- Health care management.
- Health Care Management & Economics--Penn dissertations.
- Penn dissertations--Health Care Management & Economics.
- Local Subjects:
- Health care management.
- Health Care Management & Economics--Penn dissertations.
- Penn dissertations--Health Care Management & Economics.
- Genre:
- Academic theses.
- Physical Description:
- 1 online resource (128 pages)
- Contained In:
- Dissertations Abstracts International 83-03B.
- Place of Publication:
- [Philadelphia, Pennsylvania] : University of Pennsylvania ; Ann Arbor : ProQuest Dissertations & Theses, 2021.
- Language Note:
- English
- System Details:
- Mode of access: World Wide Web.
- text file
- Summary:
- Manufacturer-sponsored copay assistance is an increasingly common and controversial practice in the US prescription drug industry. While manufacturers claim that their "copay coupons" help underinsured patients access valuable therapies, insurers are concerned that the discounts undermine cost-sharing as a means to address moral hazard and constrain prices. To date, research and policy on coupons have largely focused on coupons offered for branded drugs with generic equivalents. Much less is understood about coupons for branded drugs without generic equivalents, despite the fact that they comprise over half of all couponed drugs. In this paper, I develop an economic model of coupons and show that coupons may raise spending through both higher prices and higher quantities. Importantly, I also show that the effect of coupons on total welfare is ambiguous and depends in part on whether a generic equivalent is available. In a complementary empirical analysis, I combine a novel dataset of coupon offers with administrative claims data from a large national insurer to estimate the effects of coupon introductions between 2015 and 2018. I use difference-in-difference methods to address the potential endogeneity of coupon offers and introduce a measure of coupon exposure that exploits variation in cost-sharing across insurance plans. I find that for brands with a generic equivalent available, coupons increased prescription fills by 6%. However, coupons had limited, if any, impacts on utilization of brands that did not face generic competition. I also find evidence that coupons undermine the role of generic competition in constraining branded drug prices. Policy-makers should pursue restrictions on coupon use for branded drugs in the presence of generic equivalents and support further research on coupons in their absence.
- Notes:
- Source: Dissertations Abstracts International, Volume: 83-03, Section: B.
- Advisors: Alpert, Abby; Pauly, Mark V.; Committee members: Fang, Hanming; Lucarelli, Claudio ; DeVries, Andrea.
- Department: Health Care Management & Economics.
- Ph.D. University of Pennsylvania 2021.
- Local Notes:
- School code: 0175
- ISBN:
- 9798535568966
- Access Restriction:
- Restricted for use by site license.
- This item is not available from ProQuest Dissertations & Theses.
- This item must not be sold to any third party vendors.
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