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Empirical evidence of risk penalties for NTI Drugs

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  • Elissa Philip Gentry

    (University of Toulouse Capitole)

Abstract

Drug innovations can outpace regulatory drug approval processes designed to control risk, creating heterogeneous risks among approved drugs. This paper estimates a price model for risky narrow therapeutic index (NTI) drugs. The traditional generic approval process has been criticized as insufficient to guarantee therapeutic equivalence in NTI drugs, leading to higher risks of toxicity or ineffectiveness when a patient switches from a brand-name version of an NTI to a generic version, or between generic versions. Using data from the Medical Expenditure Panel Survey, this paper finds evidence of a significant price penalty for NTI drugs. The paper also finds a smaller gap between brand-name and generic prices for NTI drugs than for non-NTI drugs, consistent with costly switching. An analysis of drug consumption bundles also supports this theory. These results show that despite the many information asymmetries and agency issues in the pharmaceutical market, there is evidence of sensitivity to risk in price and consumption behavior.

Suggested Citation

  • Elissa Philip Gentry, 2019. "Empirical evidence of risk penalties for NTI Drugs," Journal of Risk and Uncertainty, Springer, vol. 58(2), pages 219-244, June.
    • Handle: RePEc:kap:jrisku:v:58:y:2019:i:2:d:10.1007_s11166-019-09304-6
    DOI: 10.1007/s11166-019-09304-6
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    References listed on IDEAS

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    1. H. Gothe & I. Schall & K. Saverno & M. Mitrovic & A. Luzak & D. Brixner & U. Siebert, 2015. "The Impact of Generic Substitution on Health and Economic Outcomes: A Systematic Review," Applied Health Economics and Health Policy, Springer, vol. 13(1), pages 21-33, August.
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    5. Nabin Munirul Haque & Mohan Vijay & Nicholas Aaron & Sgro Pasquale M., 2012. "Therapeutic Equivalence and the Generic Competition Paradox," The B.E. Journal of Economic Analysis & Policy, De Gruyter, vol. 12(1), pages 1-26, November.
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    Cited by:

    1. W. Kip Viscusi, 2019. "Risk guideposts for a safer society: Introduction and overview," Journal of Risk and Uncertainty, Springer, vol. 58(2), pages 101-119, June.

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