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Does competition stimulate drug utilization? The impact of changes in market structure on US drug prices, marketing and utilization

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  • Duflos, Gautier
  • Lichtenberg, Frank R.

Abstract

Microeconomic theory implies that the demand for prescription drugs should be inversely related to drug prices and directly related to marketing expenditure. Changes in market structure due to patent expiration or other factors is likely to reduce both the average price of a drug and marketing expenditure, so the effect of increased competition on total utilization of a drug is theoretically indeterminate. We use longitudinal, molecule-level data on virtually all prescription drugs sold during the period 2000–2004 to analyze the impact of changes in market structure (primarily resulting from patent expiration) on U.S. drug prices, marketing, and utilization. Price and marketing expenditure both decline by about 50–60% in the years immediately following generic entry, but the number of prescriptions remains essentially constant during those years. The two effects of increased competition on utilization – positive (via price), and negative (via marketing) – almost exactly offset one another, so the net effect of patent expiration on drug utilization is zero.

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  • Duflos, Gautier & Lichtenberg, Frank R., 2012. "Does competition stimulate drug utilization? The impact of changes in market structure on US drug prices, marketing and utilization," International Review of Law and Economics, Elsevier, vol. 32(1), pages 95-109.
    • Handle: RePEc:eee:irlaec:v:32:y:2012:i:1:p:95-109
    DOI: 10.1016/j.irle.2011.08.003
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    Cited by:

    1. Katharina Elisabeth Fischer & Tom Stargardt, 2016. "The diffusion of generics after patent expiry in Germany," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 17(8), pages 1027-1040, November.
    2. Castanheira, Micael & Ornaghi, Carmine & Siotis, Georges, 2019. "The unexpected consequences of generic entry," Journal of Health Economics, Elsevier, vol. 68(C).
    3. Daniel J. Hemel & Lisa Larrimore Ouellette, 2023. "The Generic Drug Trilemma," Entrepreneurship and Innovation Policy and the Economy, University of Chicago Press, vol. 2(1), pages 41-77.
    4. David Zimmer, 2018. "Did the Demand for Crestor Shrink when Lipitor’s Patent Expired?," Journal of Industry, Competition and Trade, Springer, vol. 18(2), pages 139-149, June.
    5. Frank R. Lichtenberg, 2019. "How Many Life-Years Have New Drugs Saved? A 3-Way Fixed-Effects Analysis of 66 Diseases in 27 Countries, 2000-2013," NBER Working Papers 25483, National Bureau of Economic Research, Inc.
    6. Frank R. Lichtenberg, 2014. "The Impact of Pharmaceutical Innovation on Disability Days and the Use of Medical Services in the United States, 1997-2010," Journal of Human Capital, University of Chicago Press, vol. 8(4), pages 432-480.

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