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74 records from EconBiz based on author Name
1. Health insurance menu design for large employers
Ho, Katherine; Lee, Robin S.;2023
Type: Aufsatz in Zeitschrift; Article in journal;
Availability: Link Link
2. How Do Copayment Coupons Affect Branded Drug Prices and Quantities Purchased?
abstractDrug copayment coupons to reduce patient cost-sharing have become nearly ubiquitous for high-priced brand-name prescription drugs. Medicare bans such coupons on the grounds that they are kickbacks that induce utilization, but they are commonly used by commercially-insured enrollees. We estimate the causal effects of coupons for branded drugs without bioequivalent generics using variation in coupon introductions over time and comparing differential responses across enrollees in commercial and Medicare Advantage plans. Using data on net-of-rebate prices and quantities from a large Pharmacy Benefits Manager, we find that coupons increase quantity sold by 21-23% for the commercial segment relative to Medicare Advantage in the year after introduction, but do not differentially impact net-of-rebate prices, at least in the short-run. To quantify the equilibrium price effects of coupons, we employ individual-level data to estimate a discrete choice model of demand for multiple sclerosis drugs. We use our demand estimates to parameterize a model of drug price negotiations. For this category of drugs, we estimate that coupons raise negotiated prices by 8% and result in just under $1 billion in increased U.S. spending annually. Combined, the results suggest copayment coupons increase spending on couponed drugs without bioequivalent generics by up to 30 percent
Dafny, Leemore S.; Ho, Katherine; Kong, Edward;2022
Type: Arbeitspapier; Working Paper; Graue Literatur; Non-commercial literature;
Availability: Link Link
Citations: 4 (based on OpenCitations)
3. Health Insurance Menu Design for Large Employers
abstractWe provide a framework for large employers designing a menu of health plan offerings that differ on both financial and non-financial dimensions. Using detailed administrative data from Harvard University, we estimate a model of plan choice and utilization, and evaluate the benefits of cost sharing and plan variety. For this population of employed consumers, and a single plan with a generous out-of-pocket maximum and zero deductible, we find that modest cost sharing of approximately 30% maximizes average employee surplus. Further gains from offering choice are limited if based solely on financial characteristics, but can be meaningful if paired with differentiation along other dimensions where consumer preferences are correlated with efficient coverage levels
Ho, Katherine; Lee, Robin S.;2022
Availability: Link
4. Contracting over Pharmaceutical Formularies and Rebates
abstractWe investigate how formularies used by pharmacy benefit managers (PBMs) can affect manufacturer rebates for branded drugs. We first present a theoretical model of multidimensional contracting in which a PBM negotiates with drug manufacturers over menus of formulary-contingent rebate payments and then selects a formulary. We then estimate how formulary placement affects drug demand for statins using data from Princeton University, a large employer that contracts with a single PBM to offer prescription drug coverage to its employees. Using our theoretical model and demand estimates, we predict how rebates are affected by the use of a preferred tier in the formulary or the ability to exclude a drug from coverage. Our predictions align with aggregate rebate data, and we find that allowing a PBM to place branded drugs on preferred and non-preferred tiers can substantially increase negotiated rebate payments
Ho, Katherine; Lee, Robin S.;2024
Type: Arbeitspapier; Working Paper; Graue Literatur; Non-commercial literature;
Availability: Link Link
5. Evaluating Pharmaceutical Policy Options
abstractOur calculations indicate that currently proposed U.S. policies to reduce pharmaceutical prices, though particularly beneficial for low-income and elderly populations, could dramatically reduce firms' investment in highly welfare-improving R&D. The U.S. subsidizes the worldwide pharmaceutical market. One reason is U.S. prices are higher than elsewhere. If each drug had a single international price across the highest-income OECD countries, and total pharmaceutical firm profits were held fixed, then U.S. prices would fall by half and every other country's prices would increase (by 28 to 300%). International prices would maintain firms' R&D incentives and more equitably share the costs of pharmaceutical research
Ho, Katherine; Pakes, Ariel;2024
Type: Arbeitspapier; Working Paper; Graue Literatur; Non-commercial literature;
Availability: Link Link
6. Market segmentation and competition in health insurance
Dickstein, Michael J.; Ho, Katherine; Mark, Nathaniel;2024
Type: Aufsatz in Zeitschrift; Article in journal;
Availability: Link Link
7. Market Segmentation and Competition in Health Insurance
abstractIn the United States, households obtain health insurance through distinct market segments. We explore the economics of this segmentation by comparing coverage provided through small employers versus the individual marketplace. Using data from Oregon, we find households with group coverage spend 26% less on covered health care than households with individual coverage yet face higher markups. We develop a model of plan choice and health spending to estimate preferences in both markets and evaluate integration policies. In our setting, pooling can both mitigate adverse selection in the individual market and benefit small group households without raising taxpayer costs
Dickstein, Michael J.; Ho, Katherine; Mark, Nathaniel D.;2021
Type: Arbeitspapier; Working Paper; Graue Literatur; Non-commercial literature;
Availability: Link Link
Citations: 3 (based on OpenCitations)
8. Industrial Organization of Health Care Markets
abstractIn this paper we outline the tools that have been developed to model and analyze competition and regulation in health care markets, and describe particular papers that apply them to policy-relevant questions. We focus particularly on the I.O. models and empirical methods and analyses that researchers have formulated to address policy-relevant questions, although we also provide an overview of the institutional facts and findings that inform them. We divide the chapter into two broad sections: (i) papers considering competition and price-setting among insurers and providers and (ii) papers focused specifically on insurance and market design. The former set of papers is largely concerned with models of oligopolistic competition; it is often focused on the US commercial insurance market where prices are market-determined rather than being set administratively. The latter focuses on insurance market design with an emphasis on issues raised by asymmetric information, leading to adverse selection and moral hazard. In addition, we discuss the literature on consumer choice frictions in this market and the significant implications of those frictions for I.O. questions
Handel, Benjamin R.; Ho, Katherine;2021
Type: Arbeitspapier; Working Paper; Graue Literatur; Non-commercial literature;
Availability: Link Link
Citations: 1 (based on OpenCitations)
9. Health Insurance Menu Design for Large Employers
abstractWe explore the challenges faced by a large employer designing a health insurance plan menu for its employees. Using detailed administrative data from Harvard University, we estimate a model of plan choice and utilization, and evaluate the benefits of cost sharing and plan variety. For a single plan with a generous out-of-pocket maximum, we find that a modest coinsurance rate of approximately 30% with a zero deductible maximizes average employee surplus. Gains from offering choice are limited if based solely on financial dimensions, but can be economically significant if paired with other features that appeal to sicker households
Ho, Katherine; Lee, Robin S.;2020
Availability: Link Link
Citations: 4 (based on OpenCitations)
10. Health insurance menu design for large employers
Ho, Katherine; Lee, Robin S.;2020
Type: Graue Literatur; Non-commercial literature; Arbeitspapier; Working Paper;
Availability: Link
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