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How Do Copayment Coupons Affect Branded Drug Prices and Quantities Purchased?

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  • Leemore Dafny
  • Kate Ho
  • Edward Kong

Abstract

We estimate the causal effects of drug copayment coupons, which reduce consumer cost sharing for branded prescription drugs, on net-of-rebate price and quantities sold. We show that coupon introductions increase the quantity of drugs without generic substitutes sold by 23–25 percent for the commercial segment relative to Medicare Advantage, where coupons are banned. To quantify the resulting equilibrium price effects, we estimate a discrete choice model of demand for multiple sclerosis drugs and simulate a model of drug price negotiations. We estimate that net-of-rebate prices are 8 percent higher due to coupons being offered for most of these drugs.

Suggested Citation

  • Leemore Dafny & Kate Ho & Edward Kong, 2024. "How Do Copayment Coupons Affect Branded Drug Prices and Quantities Purchased?," American Economic Journal: Economic Policy, American Economic Association, vol. 16(3), pages 314-346, August.
    • Handle: RePEc:aea:aejpol:v:16:y:2024:i:3:p:314-46
    DOI: 10.1257/pol.20220355
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    References listed on IDEAS

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    1. Gautam Gowrisankaran & Aviv Nevo & Robert Town, 2015. "Mergers When Prices Are Negotiated: Evidence from the Hospital Industry," American Economic Review, American Economic Association, vol. 105(1), pages 172-203, January.
    2. Ernst R. Berndt & Rena M. Conti & Stephen J. Murphy, 2017. "The Landscape of US Generic Prescription Drug Markets, 2004-2016," NBER Working Papers 23640, National Bureau of Economic Research, Inc.
    3. Leemore Dafny & Christopher Ody & Matt Schmitt, 2017. "When Discounts Raise Costs: The Effect of Copay Coupons on Generic Utilization," American Economic Journal: Economic Policy, American Economic Association, vol. 9(2), pages 91-123, May.
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    More about this item

    JEL classification:

    • G22 - Financial Economics - - Financial Institutions and Services - - - Insurance; Insurance Companies; Actuarial Studies
    • I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health
    • L65 - Industrial Organization - - Industry Studies: Manufacturing - - - Chemicals; Rubber; Drugs; Biotechnology; Plastics

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