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  1. Restrict the Middleman?
    Quantitative Models of PBM Regulations and Their Consequences
    Autor*in: Mulligan, Casey B.
    Erschienen: March 2023
    Verlag:  National Bureau of Economic Research, Cambridge, Mass

    This paper provides the first quantitative economic models of pharmacy benefit management regulation. The price-theoretic models allow for various market frictions and imperfections including market power, coordination costs, tax distortions, and... mehr

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    Sächsische Landesbibliothek - Staats- und Universitätsbibliothek Dresden
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    Universitätsbibliothek Freiburg
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    Helmut-Schmidt-Universität, Universität der Bundeswehr Hamburg, Universitätsbibliothek
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    Staats- und Universitätsbibliothek Hamburg Carl von Ossietzky
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    Technische Informationsbibliothek (TIB) / Leibniz-Informationszentrum Technik und Naturwissenschaften und Universitätsbibliothek
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    This paper provides the first quantitative economic models of pharmacy benefit management regulation. The price-theoretic models allow for various market frictions and imperfections including market power, coordination costs, tax distortions, and incomplete innovation incentives. A rigorous economic interpretation is provided for what are sometimes called "rebate walls" or "rebate traps." Applicable types of regulation include rebate rules, such as the HHS rebate rule and the Insulin Act; disclosure requirements such as the PBM Transparency Act of 2023; and pharmacy contract restrictions such as the CMS Medicare rule to take effect in 2024. Utilization of brands and generics, plan spending, cost sharing, spillovers to nonpharmacy medical spending, government budgets, and the pace of drug innovation are among the outcomes tracked by the open-source model

     
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    Sprache: Englisch
    Medientyp: Buch (Monographie)
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    Schriftenreihe: NBER working paper series ; no. w30998
    Schlagworte: Pharmahandel; Regulierung; Gesundheitsmarkt; Arzneimittelmarkt; Unvollkommener Markt; Wettbewerbspolitik; USA; Oligopoly and Other Forms of Market Imperfection; Social Choice; Clubs; Committees; Associations; Analysis of Health Care Markets; Health Insurance, Public and Private; Transactional Relationships; Contracts and Reputation; Networks; Economics of Regulation
    Umfang: 1 Online-Ressource, illustrations (black and white)
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  2. Digital Hermits
    Autor*in: Miklós-Thal, Jeanine; Goldfarb, Avi; Haviv, Avery M.; Tucker, Catherine
    Erschienen: February 2023
    Verlag:  National Bureau of Economic Research, Cambridge, Mass

    When a user shares multi-dimensional data about themselves with a firm, the firm learns about the correlations of different dimensions of user data. We incorporate this type of learning into a model of a data market in which a firm acquires data from... mehr

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    Universitätsbibliothek Freiburg
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    Standort:
    Helmut-Schmidt-Universität, Universität der Bundeswehr Hamburg, Universitätsbibliothek
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    Standort:
    Staats- und Universitätsbibliothek Hamburg Carl von Ossietzky
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    Technische Informationsbibliothek (TIB) / Leibniz-Informationszentrum Technik und Naturwissenschaften und Universitätsbibliothek
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    ZBW - Leibniz-Informationszentrum Wirtschaft, Standort Kiel
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    When a user shares multi-dimensional data about themselves with a firm, the firm learns about the correlations of different dimensions of user data. We incorporate this type of learning into a model of a data market in which a firm acquires data from users with privacy concerns. User data is multi-dimensional, and each user can share no data, only non-sensitive data, or their full data with the firm. As the firm collects more data and becomes better at drawing inferences about a user's privacy-sensitive data from their non-sensitive data, the share of new users who share no data ("digital hermits") grows. At the same time, the share of new users who share their full data also grows. The model therefore predicts a polarization of users' data sharing choices away from non-sensitive data sharing to no sharing and full sharing

     
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    Schriftenreihe: NBER working paper series ; no. w30920
    Schlagworte: Kundendaten; Personenbezogene Daten; Konsumentenverhalten; Digitale Plattform; Regulation and Industrial Policy; Economics of Regulation; Information and Internet Services; Computer Software; Marketing and Advertising
    Umfang: 1 Online-Ressource, illustrations (black and white)
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  3. Do Conflict of Interests Disclosures Work?
    Evidence from Citations in Medical Journals
    Autor*in: Leuz, Christian; Malani, Anup; Muhn, Maximilian; Jakab, László
    Erschienen: February 2023
    Verlag:  National Bureau of Economic Research, Cambridge, Mass

    Financial ties between drug companies and medical researchers are thought to bias studies published in medical journals. To enable readers to account for such bias, most medical journals require authors to disclose potential conflicts of interest. We... mehr

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    Universitätsbibliothek Freiburg
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    Helmut-Schmidt-Universität, Universität der Bundeswehr Hamburg, Universitätsbibliothek
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    Staats- und Universitätsbibliothek Hamburg Carl von Ossietzky
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    Technische Informationsbibliothek (TIB) / Leibniz-Informationszentrum Technik und Naturwissenschaften und Universitätsbibliothek
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    ZBW - Leibniz-Informationszentrum Wirtschaft, Standort Kiel
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    Financial ties between drug companies and medical researchers are thought to bias studies published in medical journals. To enable readers to account for such bias, most medical journals require authors to disclose potential conflicts of interest. We examine whether disclosure reduces article citations, indicating a discount. A challenge to estimating this effect is selection as drug companies may seek out higher quality authors. Our analysis confirms this positive association. Including observable controls for article and author quality attenuates but does not eliminate this relation. We perform three tests. First, we show that the positive association is weaker for review articles, which are more susceptible to bias. Second, we examine article recommendations to family physicians among articles that are a priori more homogenous in quality. We find a significantly negative association between disclosure and expert recommendations, consistent with discounting. Third, we conduct an analysis within author and article, exploiting journal policy changes that result in conflict disclosure by an author. We examine the effect of this disclosure on citations to a previously published article by the same author. This analysis reveals a negative citation effect. Overall, our evidence is consistent with the notion that other researchers discount articles with disclosed conflicts

     
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    Schriftenreihe: NBER working paper series ; no. w30927
    Schlagworte: Forschungskooperation; Pharmaindustrie; Wissenschaftler; Medizin; Auskunftspflicht; Wissenschaftliche Publikation; Bibliometrie; Search; Learning; Information and Knowledge; Communication; Belief; Unawareness; Expectations; Speculations; Government Policy and Regulation; General; Economics of Regulation; General; Innovation and Invention: Processes and Incentives
    Umfang: 1 Online-Ressource, illustrations (black and white)
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  4. Preferences for Firearms and Their Implications for Regulation
    Autor*in: Moshary, Sarah; Shapiro, Bradley; Drango, Sara
    Erschienen: February 2023
    Verlag:  National Bureau of Economic Research, Cambridge, Mass

    This paper estimates consumer demand for firearms with the aim of predicting the likely impacts of firearm regulations on the number and types of guns in circulation. We first conduct a stated-choice-based conjoint analysis and estimate an... mehr

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    Universitätsbibliothek Freiburg
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    Helmut-Schmidt-Universität, Universität der Bundeswehr Hamburg, Universitätsbibliothek
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    Staats- und Universitätsbibliothek Hamburg Carl von Ossietzky
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    Technische Informationsbibliothek (TIB) / Leibniz-Informationszentrum Technik und Naturwissenschaften und Universitätsbibliothek
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    ZBW - Leibniz-Informationszentrum Wirtschaft, Standort Kiel
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    This paper estimates consumer demand for firearms with the aim of predicting the likely impacts of firearm regulations on the number and types of guns in circulation. We first conduct a stated-choice-based conjoint analysis and estimate an individual-level demand model for firearms. We validate our estimates using aggregate moments from observational data. Next, we use our estimates to simulate changes in the number and types of guns in circulation under alternative regulations. Importantly, we find that bans or restrictions that specifically target "assault weapons" increase demand for handguns, which are associated with the vast majority of firearm-related violence. We provide distributions of consumer surplus under counterfactuals and discuss how those distributions could be useful for crafting policy

     
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    Schriftenreihe: NBER working paper series ; no. w30934
    Schlagworte: Waffe; Nachfrage; Waffenrecht; Preiselastizität; Substitutionseffekt; USA; Bayesian Analysis: General; Survey Methods; Sampling Methods; Externalities; Redistributive Effects; Environmental Taxes and Subsidies; Government Policy; Regulation; Public Health; General; Economics of Regulation; Marketing; Government Policy and Regulation
    Umfang: 1 Online-Ressource, illustrations (black and white)
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  5. The Economics of Digital Privacy
    Autor*in: Goldfarb, Avi; Que, Verina F.
    Erschienen: February 2023
    Verlag:  National Bureau of Economic Research, Cambridge, Mass

    There has been increasing attention to privacy in the media and in regulatory discussions. This is a consequence of the increased usefulness of digital data. The literature has emphasized the benefits and costs of digital data flows to consumers and... mehr

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    Universitätsbibliothek Freiburg
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    Helmut-Schmidt-Universität, Universität der Bundeswehr Hamburg, Universitätsbibliothek
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    Standort:
    Staats- und Universitätsbibliothek Hamburg Carl von Ossietzky
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    Technische Informationsbibliothek (TIB) / Leibniz-Informationszentrum Technik und Naturwissenschaften und Universitätsbibliothek
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    ZBW - Leibniz-Informationszentrum Wirtschaft, Standort Kiel
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    There has been increasing attention to privacy in the media and in regulatory discussions. This is a consequence of the increased usefulness of digital data. The literature has emphasized the benefits and costs of digital data flows to consumers and firms. The benefits arise in the form of data-driven innovation, higher quality products and services that match consumer needs, and increased profits. The costs relate to intrinsic and instrumental values of privacy. Under standard economic assumptions, this framing of a cost-benefit tradeoff might suggest little role for regulation beyond ensuring consumers are appropriately informed in a robust competitive environment. The empirical literature thus far has focused on this direct cost-benefit assessment, examining how privacy regulations have affected various market outcomes. However, an increasing body of theory work emphasizes externalities related to data flows. These externalities, both positive and negative, suggest benefits to the targeted regulation of digital privacy

     
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    Schriftenreihe: NBER working paper series ; no. w30943
    Schlagworte: Digitale Güter; Personenbezogene Daten; Datenschutz; Economics of Regulation; Information and Internet Services; Computer Software
    Umfang: 1 Online-Ressource, illustrations (black and white)
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  6. Dynamic Pricing Regulation and Welfare in Insurance Markets
    Autor*in: Aizawa, Naoki; Ko, Ami
    Erschienen: February 2023
    Verlag:  National Bureau of Economic Research, Cambridge, Mass

    While the traditional role of insurers is to provide protection against idiosyncratic risks of individuals, insurers themselves face substantial uncertainties due to aggregate shocks. To prevent insurers from passing through aggregate risks to... mehr

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    Sächsische Landesbibliothek - Staats- und Universitätsbibliothek Dresden
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    Universitätsbibliothek Freiburg
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    Helmut-Schmidt-Universität, Universität der Bundeswehr Hamburg, Universitätsbibliothek
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    Standort:
    Staats- und Universitätsbibliothek Hamburg Carl von Ossietzky
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    Technische Informationsbibliothek (TIB) / Leibniz-Informationszentrum Technik und Naturwissenschaften und Universitätsbibliothek
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    ZBW - Leibniz-Informationszentrum Wirtschaft, Standort Kiel
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    While the traditional role of insurers is to provide protection against idiosyncratic risks of individuals, insurers themselves face substantial uncertainties due to aggregate shocks. To prevent insurers from passing through aggregate risks to consumers, governments have increasingly adopted dynamic pricing regulations that limit insurers' ability to change premiums over time. This paper develops and estimates an equilibrium model with dynamic pricing and firm entry and uses it to evaluate the design of dynamic pricing regulations in the U.S. long-term care insurance (LTCI) market. We find that stricter dynamic pricing regulation lowers social welfare as the benefit from improved premium stability is outweighed by the cost of reduced insurer participation. The welfare loss from stricter dynamic pricing regulation could be mitigated if the government also expands public LTCI through Medicaid

     
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    Schriftenreihe: NBER working paper series ; no. w30952
    Schlagworte: Versicherungsbeitrag; Preisregulierung; Versicherungsmarkt; Markteintritt; Wettbewerb; Wohlfahrtsanalyse; USA; Household Saving; Personal Finance; Insurance; Insurance Companies; Actuarial Studies; Health Insurance, Public and Private; Production, Pricing, and Market Structure; Size Distribution of Firms; Economics of Regulation
    Umfang: 1 Online-Ressource, illustrations (black and white)
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  7. Transmission Impossible? Prospects for Decarbonizing the US Grid
    Autor*in: Davis, Lucas W.; Hausman, Catherine; Rose, Nancy L.
    Erschienen: June 2023
    Verlag:  National Bureau of Economic Research, Cambridge, Mass

    Encouraged by the declining cost of grid-scale renewables, recent analyses conclude that the United States could reach net zero carbon dioxide emissions by 2050 at relatively low cost using currently available technologies. While the cost of... mehr

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    Universitätsbibliothek Freiburg
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    Helmut-Schmidt-Universität, Universität der Bundeswehr Hamburg, Universitätsbibliothek
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    Staats- und Universitätsbibliothek Hamburg Carl von Ossietzky
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    Technische Informationsbibliothek (TIB) / Leibniz-Informationszentrum Technik und Naturwissenschaften und Universitätsbibliothek
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    ZBW - Leibniz-Informationszentrum Wirtschaft, Standort Kiel
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    Encouraged by the declining cost of grid-scale renewables, recent analyses conclude that the United States could reach net zero carbon dioxide emissions by 2050 at relatively low cost using currently available technologies. While the cost of renewable generation has declined dramatically, integrating these renewables would require a large expansion in transmission to deliver that power. Already there is growing evidence that the United States has insufficient transmission capacity, and current levels of annual investment are well below what would be required for a renewables-dominated system. We describe a variety of challenges that make it difficult to build new transmission and potential policy responses to mitigate them, as well as possible substitutes for some new transmission capacity

     
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    Schriftenreihe: NBER working paper series ; no. w31377
    Schlagworte: Stromnetz; Elektrizitätsversorgung; Erneuerbare Energie; Treibhausgas-Emissionen; USA; Economics of Regulation; Electric Utilities; Demand and Supply; Prices; Government Policy
    Umfang: 1 Online-Ressource, illustrations (black and white)
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  8. The Economic Determinants of Heat Pump Adoption
    Autor*in: Davis, Lucas W.
    Erschienen: June 2023
    Verlag:  National Bureau of Economic Research, Cambridge, Mass

    One concern with subsidies for low-carbon technologies is that they tend to go predominantly to high-income households. Previous research has shown, for example, that the top income quintile receives 60% of subsidies for rooftop solar and 90% of... mehr

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    Universitätsbibliothek Freiburg
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    Helmut-Schmidt-Universität, Universität der Bundeswehr Hamburg, Universitätsbibliothek
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    Staats- und Universitätsbibliothek Hamburg Carl von Ossietzky
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    Technische Informationsbibliothek (TIB) / Leibniz-Informationszentrum Technik und Naturwissenschaften und Universitätsbibliothek
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    ZBW - Leibniz-Informationszentrum Wirtschaft, Standort Kiel
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    One concern with subsidies for low-carbon technologies is that they tend to go predominantly to high-income households. Previous research has shown, for example, that the top income quintile receives 60% of subsidies for rooftop solar and 90% of subsidies for electric vehicles. This paper finds that heat pumps are an important exception. Using newly available U.S. nationally representative data, the paper finds that there is remarkably little correlation between heat pump adoption and household income. Nationwide, 15% of U.S. households have a heat pump as their primary heating equipment, and adoption levels are essentially identical for all income levels ranging from the bottom of the income distribution (<$30,000 annually) to the top ($150,000+). Instead, the paper shows that heat pump adoption is strongly correlated with geography, climate, and electricity prices

     
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    Schriftenreihe: NBER working paper series ; no. w31344
    Schlagworte: Wärmepumpe; Innovationsakzeptanz; Innovationsdiffusion; USA; Externalities; Redistributive Effects; Environmental Taxes and Subsidies; Economics of Regulation; Demand and Supply; Prices; Alternative Energy Sources; Government Policy; Climate; Natural Disasters and Their Management; Global Warming
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  9. A Model of Influencer Economy
    Autor*in: Cong, Lin William; Li, Siguang
    Erschienen: May 2023
    Verlag:  National Bureau of Economic Research, Cambridge, Mass

    With the rise of social media and streaming platforms, firms and brand-owners increasingly depend on influencers to attract consumers, who care about both common product quality and consumer-influencer interaction. Sellers thus compete in both... mehr

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    Universitätsbibliothek Freiburg
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    Helmut-Schmidt-Universität, Universität der Bundeswehr Hamburg, Universitätsbibliothek
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    Staats- und Universitätsbibliothek Hamburg Carl von Ossietzky
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    ZBW - Leibniz-Informationszentrum Wirtschaft, Standort Kiel
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    With the rise of social media and streaming platforms, firms and brand-owners increasingly depend on influencers to attract consumers, who care about both common product quality and consumer-influencer interaction. Sellers thus compete in both influencer and product markets. As outreach and distribution technologies improve, influencer payoffs and income inequality change non-monotonically. More powerful influencers sell better-quality products, but pluralism in style mitigates market concentration by effectively differentiating consumer experience. Influencer style dispersion substitutes horizontal product differentiation but serves as either complement (small dispersion) or substitute (large dispersion) to vertical product differentiation. The assortative matching between sellers and influencers remains under endogenous influence-building, with the maximal differentiation principle recovered in the limit of costless style acquisition. Meanwhile, influencers may under-invest in consumer outreach to avoid exacerbating price competition. Finally, while requiring balanced seller-influencer matching can encourage seller competition, uni-directional exclusivity can improve welfare for sufficiently differentiated products and uncrowded influencer markets

     
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    Schriftenreihe: NBER working paper series ; no. w31243
    Schlagworte: Influencer; Marketing; Online-Marketing; Werbung; Vertrieb; Production, Pricing, and Market Structure; Size Distribution of Firms; General; Economics of Regulation; Marketing; Advertising
    Umfang: 1 Online-Ressource, illustrations (black and white)
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  10. Ending Pay for PBM Performance
    Consequences for Prescription Drug Prices, Utilization, and Government Spending
    Autor*in: Mulligan, Casey B.
    Erschienen: September 2023
    Verlag:  National Bureau of Economic Research, Cambridge, Mass

    Proposed "delinking" legislation would prohibit Pharmacy Benefit Managers (PBMs) from being remunerated based on the rebates and discounts they negotiate for drug insurance plans serving Medicare beneficiaries. This policy would significantly change... mehr

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    Sächsische Landesbibliothek - Staats- und Universitätsbibliothek Dresden
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    Universitätsbibliothek Freiburg
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    Helmut-Schmidt-Universität, Universität der Bundeswehr Hamburg, Universitätsbibliothek
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    Staats- und Universitätsbibliothek Hamburg Carl von Ossietzky
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    Proposed "delinking" legislation would prohibit Pharmacy Benefit Managers (PBMs) from being remunerated based on the rebates and discounts they negotiate for drug insurance plans serving Medicare beneficiaries. This policy would significantly change drug pricing and utilization and shift billions of dollars annually from patients and taxpayers to drug manufacturers and retail pharmacy companies. Annual federal spending on Medicare Part D premiums would increase $3 billion to $10 billion plus any concomitant increase in Medicare subsidies for out-of-pocket expenses. All of these consequences stem from the fact that PBMs are hired to obtain rebates and discounts but would no longer be compensated based on their results. The quantitative estimates utilize a large body of economic research showing how much "pay for performance" matters for economic outcomes. The price-theoretic models also account for various market frictions and imperfections including market power, coordination costs, tax distortions, and incomplete innovation incentives

     
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    Format: Online
    Schriftenreihe: NBER working paper series ; no. w31667
    Schlagworte: Arzneimittel; Pharmahandel; Gesetzliche Krankenversicherung; Pharmaindustrie; Arzneimittelrecht; USA; Oligopoly and Other Forms of Market Imperfection; Social Choice; Clubs; Committees; Associations; Health Insurance, Public and Private; Human Capital; Skills; Occupational Choice; Labor Productivity; Transactional Relationships; Contracts and Reputation; Networks; Economics of Regulation
    Umfang: 1 Online-Ressource, illustrations (black and white)
    Bemerkung(en):

    Hardcopy version available to institutional subscribers