Many countries with national health care providers and health insurances regulate the market for pharmaceuticals to steer drug demand and to control expenses. For example, they introduce reference pricing or tiered co-payments to enhance drug substitution and competition. Since 2006, Germany...

Procurement within the NHS is attracting increasing research and policy interest. However, most of the emphasis has been on the buyer (the NHS), with less attention paid to the behaviour of suppliers (often pharmaceutical companies). For medical devices very little is publicly documented about...

Very few industries are as profoundly influenced by regulation as the pharmaceutical industry. All aspects of the life-cycle of new drugs are regulated, from patent application, to marketing approval, commercial exploitation, patent expiration and competition with generics. The nature of demand...

This paper studies the impact of private equity (PE) acquisitions on quality of care in U.S. nursing homes. To do this, we examine 77 PE deals covering 1451 nursing homes between 1993 and 2017. We find significant heterogeneity in the effect of PE ownership according to levels of local market...

This paper argues that drugs are expensive not because of a lack of competition among research-based pharmaceutical companies, but because of a lack of competition in the drug approval process. Lack of competition in the drug approval process has led to exceedingly high drug development costs....

High prices and insufficient quality of care are observed in nursing homes in France. Reforms are currently under discussion, but governments are facing a dilemma : any measure of price cut is likely to affect quality and any improvement in quality would probably be inflationary. This work...

A set-aside restricts participation in procurement contests to targeted firms. Despite being widely used, its effects on actual competition and contract outcomes are ambiguous. We pool a decade of US federal procurement data to shed light on this empirical question using a two-stage approach. To...

We study the effect of the degree of exclusivity for the lowest bidder on the average price of generic pharmaceuticals in the short and long terms. Our results indicate that a 1-percentage-point gain in market share of the lowest bidder reduces average costs by 0.2% in the short term and 0.8% in...

This paper analyzes how features of the procurement system laid down by the EU Procurement Directives affect the analysis of competition in public procurement markets. It presents the bidding systems allowed under the EU rules and provides a general framework to assess competition concerns for...

This study incorporates market-level fixed effects into an analysis of panel data from Wisconsin to assess whether competitor market share influences choices of price and quality at for-profit and nonprofit nursing homes. The measured competitive effects are quite small, both between firms of...