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What Explains Generosity in the Public Financing of High-Tech Drugs? An Empirical Investigation for 25 OECD Countries and 11 Controversial Drugs

Author

Listed:
  • Katharina Böhm

    (Johannes Gutenberg University Mainz)

  • Claudia Landwehr

    (Johannes Gutenberg University Mainz)

  • Nils Steiner

    (Johannes Gutenberg University Mainz)

Abstract

In times of increasing cost pressures public health care systems in the OECD countries face the question whether and to which extent new high-tech drugs are to be financed within their public health care systems. Systematic empirical research that tries to explain across-country variation in these coverage decisions is, however, almost non-existent. We analyze an original dataset that contains coverage decisions for 11 controversial drugs in 25 OECD countries via multilevel modeling. Our results indicate that regulations to what extent a pharmaceutical is publicly financed are unrelated to wealth and general expenditure levels for health care, while societal health care systems tend to be more generous. By taking into account that rationing decisions have been (at least partially) delegated to specialized agencies in all of the countries under investigation, we also uncover suggestive evidence that institutional characteristics of the underlying decision processes matter systematically for coverage decisions.

Suggested Citation

  • Katharina Böhm & Claudia Landwehr & Nils Steiner, 2017. "What Explains Generosity in the Public Financing of High-Tech Drugs? An Empirical Investigation for 25 OECD Countries and 11 Controversial Drugs," Working Papers 1708, Gutenberg School of Management and Economics, Johannes Gutenberg-Universität Mainz.
    • Handle: RePEc:jgu:wpaper:1708
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    References listed on IDEAS

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    1. Ostrom, Elinor, 2009. "An Agenda for the Study of Institutions," Ekonomicheskaya Politika / Economic Policy, Russian Presidential Academy of National Economy and Public Administration, vol. 6, pages 89-110, December.
    2. Weaver, R. Kent, 1986. "The Politics of Blame Avoidance," Journal of Public Policy, Cambridge University Press, vol. 6(4), pages 371-398, October.
    3. -, 1986. "Agenda = Agenda," Series Históricas 8749, Naciones Unidas Comisión Económica para América Latina y el Caribe (CEPAL).
    4. Daniels, Norman & Sabin, James E., 2002. "Setting Limits Fairly: Can we learn to share medical resources?," OUP Catalogue, Oxford University Press, number 9780195149364.
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    Keywords

    Delegation; independent regulatory agencies; health care; priority setting; multilevel analysis;
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