The determinants of pricing in pharmaceuticals: are US prices really so high?

Abstract

This paper studies price determination in pharmaceutical markets using data for 25 countries, six years and a comprehensive list of products from the MIDAS IMS database. We show that market power and the quality of the product have a signi¯cantly positive impact of prices. The nationality of the producer appears to have a small and often insigni¯cant impact on prices, which suggests that countries which regulate prices have relatively little power to do it in a way that advances narrow national interest. We produce a theoretical explanation for this phenomenon based on the fact that low negotiated prices in a country would have a knock-on efect in other markets, and is thus strongly resisted by producers. Another key finding is that the U.S. has prices that are not signi¯cantly higher than those of countries with similar income levels. This, together with the former observation on the efect of the nationality of producers casts doubt on the ability of countries to pursue "free-riding" regulation.