The document discusses the topic of price transparency in healthcare. It examines price transparency from several perspectives, including whether transparency is good as an end in itself or as a means to improve outcomes. It also discusses transparency of the price-setting process versus prices obtained, and how transparency could impact competition, collusion, and prices of off-patent versus on-patent drugs. While transparency may reduce corruption and improve competition, it also potentially facilitates collusion and could result in higher prices if it reduces firms' incentives to offer low prices.
CURRENT RESEARCH ON REVERSE AUCTIONS: PART II -IMPLEMENTATION ISSUES ASSOCIAT...ijmvsc
This article serves as the second part in a two-part series that provides an overview of the reverse auction concept, building on the best research in the field of supply chain management. In this instalment, we look at the concerns involved in making reverse auctions work in practice – the implementation issues. Frist, we look at when reverse auctions should – and should not – be utilized by a buying organization. We then examine the decision rules that should be used in determining which of the competing suppliers wins the reverse auction. Next, we look at the best research available as to how the use of reverse auctions impacts the buyer-seller relationship. Finally, we examine what is in essence a “make or buy” decision in regards to whether the purchasing organization should run an auction in-house or make use of the services of a third-party “market maker.
Tender Process | A Complete Procurement GuideTender Process
All about Tenders and its Process | Here you will get all the information regarding tenders (Procurement) like what is tender, what is its process, types of tender, how to search tenders, what to do and what not to do in tendering, how to search tenders and more.... you can check our website for more details which is : http://tenderprocess.weebly.com/
CURRENT RESEARCH ON REVERSE AUCTIONS: PART II -IMPLEMENTATION ISSUES ASSOCIAT...ijmvsc
This article serves as the second part in a two-part series that provides an overview of the reverse auction concept, building on the best research in the field of supply chain management. In this instalment, we look at the concerns involved in making reverse auctions work in practice – the implementation issues. Frist, we look at when reverse auctions should – and should not – be utilized by a buying organization. We then examine the decision rules that should be used in determining which of the competing suppliers wins the reverse auction. Next, we look at the best research available as to how the use of reverse auctions impacts the buyer-seller relationship. Finally, we examine what is in essence a “make or buy” decision in regards to whether the purchasing organization should run an auction in-house or make use of the services of a third-party “market maker.
Tender Process | A Complete Procurement GuideTender Process
All about Tenders and its Process | Here you will get all the information regarding tenders (Procurement) like what is tender, what is its process, types of tender, how to search tenders, what to do and what not to do in tendering, how to search tenders and more.... you can check our website for more details which is : http://tenderprocess.weebly.com/
Many quality dimensions are hard to contract upon and are at risk of degradation when services are procured rather than produced in-house. However, procurement may foster performance-improving innovation. We assemble a large data set on elderly care services in Sweden between 1990 and 2009, including survival rates - our measure of non-contractible quality - and subjectively perceived quality of service. We estimate how procurement from private providers affects these measures using a difference-in-difference approach. The results indicate that procurement significantly increases non-contractible quality as measured by survival rate, reduces the cost per resident but does not affect subjectively perceived quality.
Based on my recent work with several co-authors this paper explores the relationship between discretion, reputation, competition and entry in procurement markets. I focus especially on public procurement, which is highly regulated for accountability and trade reasons. In Europe regulation constrains the use of past performance information to select contractors while in the US its use is encouraged. I present some novel evidence on the benefits of allowing buyers to use reputational indicators based on past performance and discuss the complementary roles of discretion and restricted competition in reinforcing relational/reputational forces, both in theory and in a new
empirical study on the effects restricted rather than open auctions. I conclude reporting preliminary results form a laboratory experiment showing that reputational mechanisms can be designed to stimulate rather than hindering new entry.
This presentation by Emmanuelle AURIOL, Professor of Economics, Toulouse 1 Capitole University, was made during the discussion “Director Disqualification and Bidder Exclusion” held at the 139th meeting of the OECD Competition Committee on 29 November 2022. More papers and presentations on the topic can be found out at https://oe.cd/ddbe
Bid rigging is illegal, anti-competitive and costs govts & taxpayers billions. The OECD Guidelines for Fighting Bid Rigging in Public Procurement and the 2012 OECD Council Recommendation help public officials to reduce the risks of bid rigging, through the careful design of public procurement tenders, and to detect bid rigging conspiracies during procurement processes. Download the guidelines at: oe.cd/gfbr (available in 26 languages).
This presentation by Robert Porter (Professor of Economics, Northwestern University, US) was made during a workshop on “Cartel screening in the digital era” held by the OECD in Paris on 30 January 2018. More papers and presentations on the topic can be found out at oe.cd/wcsde.
This presentation by Giulio Federico, Head of the Unit in the Chief Economist Team of DG Competition, European Commission, was made during the discussion “Merger Control in Dynamic Markets” held at the 18th meeting of the OECD Global Forum on Competition on 6 December 2019. More papers and presentations on the topic can be found at oe.cd/mcdym.
A study on the chain restaurants dynamic negotiation games of the optimizatio...ijcsit
In the era of meager profit, production costs often become an important factor affecting SMEs’ operating
conditions, and how to effectively reduce production costs has become an issue of in-depth consideration
for the business owners. Especially, the food and beverage (F&B) industry cannot accurately predict the
demand. It many cause demand forecast fall and excess or insufficient inventory pressure. Companies of
the F&B industry may be even unable to meet immediate customer needs. They are faced great challenges
in quick response and inventory pressure. This study carried out the product inventory model analysis of
the most recent year’s sales data of the fresh food materials for chain restaurants in a supply chain region
with raw material suppliers and demanders. Moreover, this study adopted the multi-agent dynamic strategy
game to establish the joint procurement decision model negotiation algorithm for analysis and verification
by simulation cases to achieve the design of dynamic negotiation optimization mechanism for the joint
procurement of food materials. Coupled with supply chain management 3C theory for food material
inventory management, we developed the optimization method for determining the order quantities of the
chain restaurants. For product demand forecast, we applied the commonality model, production and
delivery capacity model, and the model of consumption and replenishment based on market demand
changes in categorization and development. Moreover, with the existence of dependencies between product
demands as the demand forecast basis, we determined the appropriate inventory model accordingly.
Running head Economic Analysis of Business ProposalEconomic A.docxcharisellington63520
Running head: Economic Analysis of Business Proposal
Economic Analysis of Business Proposal 7
Introduction
The onus of this economic analysis paper centers around both the “Thomas Money Service Inc.” and “Will Bury’s Price Elasticity” scenarios that collectively constitute a monopolist market structure. (Crane, 2014) wrote that the market conditions and information concerning the pricing strategies, quantity to supply to the entire market, product differentiation, as well as patenting of the innovations dominate these scenarios. As a result of this, many dilemmas emerge under monopolistic markets given that the commodities produced are not complete substitutes rather close substitutes to each other. A big number of producers and product differentiation about the pricing strategies and the price elasticity of demand are the material factors that this manuscript is tasked to discuss.
Overview of the two scenarios
For the case of “Thomas Money Service Inc.”, the financing institution started providing credit lending facilities back in the year 1940 as a consumer finance firm.Between 1940 and 1945, the company increased its activities from issuing small loans to households to offering business loans, mortgages, and business acquisition financing.Early in the year 1946, a lucrative opportunity emerged of providing equipment financing supplementing the high market demand for forestry and equipment.The year 1951 was a year of opportunities where the company bought an equipment manufacturing firm. Consequently, the company suspended the funding of other equipment brands due to the increased manufacturing, selling, and financing its brand of forestry and building equipment.
On the other hand, Will Bury started as a mere worker at the High Tech Digital Industries, where he gathered necessary innovations skills to start his music and digital business.In the garage operation, Will increased his knowledge and entrepreneurship culture to prompt the decision of starting the digital book enterprise that he invented. Will Burry was faced with many dilemmas of how to ascertain his technological application, which kind of clientele to serve, the way of distribution of the services to the people, the demand for books, as well as the pricing strategies.
Monopolistic competition markets structure
As per the two scenarios of Will Bury and Thomas Money Services, it is crystal clear that they are examples of monopolistic market structures. This form of a market is a blend of the monopoly and perfect competition and has been called monopolistic competition or competing monopolists as stated by (Hushke, 2010). In the real world, there is neither absolute monopoly that is an absence of competition, nor perfect competition, but monopolistic competition. The products are not complete substitutes for one another, but they are close substitutes.
With respect to monopolistic competition, the number of dealers (buyers and sellers) is not large, at any rate not as lar.
Mergers & Acquisition (Return Of The Big Deal!)André Harrell
After years of stagnant activity, mergers and acqui- sitions surged in 2014, with the announcement
of more than 7,500 deals1 with a combined value exceeding $3.5 trillion. That’s an increase of more than 7 percent by number and more than 25 percent by value compared with 2013. While
that volume hasn’t yet reached the high of nearly 10,000 deals set in 2007, a new wave of activity
is clearly under way.
Factors affecting Suppliers’ Refusal to Participate in Public procurement thr...IJAEMSJORNAL
This study identified factors of the procurement process and policies that affected suppliers’ decisions to refuse to participate in public procurement. The assessment of discernment is in the extent of suppliers’ company profiles and the procurement process and policies based on the 2016 Revised Implementing Rules and Regulations of Republic Act 9184. The study used a descriptive research design. A simple random sampling method was used to selected participants for the study. A combination of a checklist, free and scaled response questionnaire was used to collect responses. The researchers were able to disseminate questionnaires to the suppliers of different government agencies in the vicinity of the Science City of Muñoz, Nueva Ecija. The study revealed that a huge number of the surveyed suppliers felt that participation in public procurement through a competitive bidding process would entail them with more obstacles and challenges than some alternative types of procurement. The study also found that the three most-cited factors affecting suppliers’ decisions to refuse in participating: the approved budget for the contract is usually too low, the time frame for the delivery is usually too short, and the process is too long.
The study seeks to contribute to the discussion on the causes of maverick buying-
MB and its impact on the procurement policy and the economy of Ghana in general. The
research methodology used in this study is qualitative. The instrument of study was based on
non standard interview with the officers that are experts on the topic at the district assemblies
where 11 districts assemblies were covered out of 22. The study revealed the following causes;
procurement practitioners find it difficult to understand the Procurement Act 663, practitioners
lack capacity both academically and professionally in the management and operationalisation
of the procurement process, the Procurement Act 663 is excessively legalistic and technical,
the Act 663 is at anomalous with market trends or practices. The study also found out that there
are lapses in monitoring for compliance of the Procurement Act 663, no examples of known
procurement practitioners punished for non compliance, lack of commitment on the part of
officialdom, organisational culture at the district level a major cause of maverick buying and
most of the procurement activities are unplanned. On the impact, the study established that MB
defeats the superseding objectives of the Public Procurement Act 663 of 2003, it is also
insidious to the aptitude to negotiate favourable terms for price of goods, services and works
due to the crumbling of spend, MB had the ability to deny the assemblies the knack to collect
data on the assemblies’ sequence of purchasing or spending thereby causing the assemblies to
lose visibility over its outlay, it also increases purchasing cost where it affects equally the
actual purchasing price and process cost, it was also disclosed that fraud and corruption can
ensue from MB. The study recommends that PPA and the ministry of education should link up
to train procurement practitioners as stipulated in Procurement Act 663 section 3(k) to improve
the awareness and knowledge of procurement processes at the district assemblies and the
nation in general. Monitoring compliance trends should also be a key part of the Public
Procurement Authority-PPA. As a matter of fact the institution responsible for sanction should
be incorporated into the enforcement unit for swift punishment to act as deterrence to others.
PPA and the districts should link up on how eProcurement systems can be implemented to
ensure compliance since the most commonly declare solution for maverick buying is the
implementation of electronic procurement.
This presentation by Ms. Jyoti Jindgar Bhanot was made at the workshop on Competition in Publicly Funded Markets (28 February 2019). Find out more at http://www.oecd.org/daf/competition/workshop-on-competition-in-publicly-funded-markets.htm
This presentation by Susan F. STONE, Head, Emerging Policy Division, Trade and Agriculture Directorate, OECD, was made during the discussion “Competition provisions in trade agreements” held at the 18th meeting of the OECD Global Forum on Competition on 5 December 2019. More papers and presentations on the topic can be found at oe.cd/cpta.
Many quality dimensions are hard to contract upon and are at risk of degradation when services are procured rather than produced in-house. However, procurement may foster performance-improving innovation. We assemble a large data set on elderly care services in Sweden between 1990 and 2009, including survival rates - our measure of non-contractible quality - and subjectively perceived quality of service. We estimate how procurement from private providers affects these measures using a difference-in-difference approach. The results indicate that procurement significantly increases non-contractible quality as measured by survival rate, reduces the cost per resident but does not affect subjectively perceived quality.
Based on my recent work with several co-authors this paper explores the relationship between discretion, reputation, competition and entry in procurement markets. I focus especially on public procurement, which is highly regulated for accountability and trade reasons. In Europe regulation constrains the use of past performance information to select contractors while in the US its use is encouraged. I present some novel evidence on the benefits of allowing buyers to use reputational indicators based on past performance and discuss the complementary roles of discretion and restricted competition in reinforcing relational/reputational forces, both in theory and in a new
empirical study on the effects restricted rather than open auctions. I conclude reporting preliminary results form a laboratory experiment showing that reputational mechanisms can be designed to stimulate rather than hindering new entry.
This presentation by Emmanuelle AURIOL, Professor of Economics, Toulouse 1 Capitole University, was made during the discussion “Director Disqualification and Bidder Exclusion” held at the 139th meeting of the OECD Competition Committee on 29 November 2022. More papers and presentations on the topic can be found out at https://oe.cd/ddbe
Bid rigging is illegal, anti-competitive and costs govts & taxpayers billions. The OECD Guidelines for Fighting Bid Rigging in Public Procurement and the 2012 OECD Council Recommendation help public officials to reduce the risks of bid rigging, through the careful design of public procurement tenders, and to detect bid rigging conspiracies during procurement processes. Download the guidelines at: oe.cd/gfbr (available in 26 languages).
This presentation by Robert Porter (Professor of Economics, Northwestern University, US) was made during a workshop on “Cartel screening in the digital era” held by the OECD in Paris on 30 January 2018. More papers and presentations on the topic can be found out at oe.cd/wcsde.
This presentation by Giulio Federico, Head of the Unit in the Chief Economist Team of DG Competition, European Commission, was made during the discussion “Merger Control in Dynamic Markets” held at the 18th meeting of the OECD Global Forum on Competition on 6 December 2019. More papers and presentations on the topic can be found at oe.cd/mcdym.
A study on the chain restaurants dynamic negotiation games of the optimizatio...ijcsit
In the era of meager profit, production costs often become an important factor affecting SMEs’ operating
conditions, and how to effectively reduce production costs has become an issue of in-depth consideration
for the business owners. Especially, the food and beverage (F&B) industry cannot accurately predict the
demand. It many cause demand forecast fall and excess or insufficient inventory pressure. Companies of
the F&B industry may be even unable to meet immediate customer needs. They are faced great challenges
in quick response and inventory pressure. This study carried out the product inventory model analysis of
the most recent year’s sales data of the fresh food materials for chain restaurants in a supply chain region
with raw material suppliers and demanders. Moreover, this study adopted the multi-agent dynamic strategy
game to establish the joint procurement decision model negotiation algorithm for analysis and verification
by simulation cases to achieve the design of dynamic negotiation optimization mechanism for the joint
procurement of food materials. Coupled with supply chain management 3C theory for food material
inventory management, we developed the optimization method for determining the order quantities of the
chain restaurants. For product demand forecast, we applied the commonality model, production and
delivery capacity model, and the model of consumption and replenishment based on market demand
changes in categorization and development. Moreover, with the existence of dependencies between product
demands as the demand forecast basis, we determined the appropriate inventory model accordingly.
Running head Economic Analysis of Business ProposalEconomic A.docxcharisellington63520
Running head: Economic Analysis of Business Proposal
Economic Analysis of Business Proposal 7
Introduction
The onus of this economic analysis paper centers around both the “Thomas Money Service Inc.” and “Will Bury’s Price Elasticity” scenarios that collectively constitute a monopolist market structure. (Crane, 2014) wrote that the market conditions and information concerning the pricing strategies, quantity to supply to the entire market, product differentiation, as well as patenting of the innovations dominate these scenarios. As a result of this, many dilemmas emerge under monopolistic markets given that the commodities produced are not complete substitutes rather close substitutes to each other. A big number of producers and product differentiation about the pricing strategies and the price elasticity of demand are the material factors that this manuscript is tasked to discuss.
Overview of the two scenarios
For the case of “Thomas Money Service Inc.”, the financing institution started providing credit lending facilities back in the year 1940 as a consumer finance firm.Between 1940 and 1945, the company increased its activities from issuing small loans to households to offering business loans, mortgages, and business acquisition financing.Early in the year 1946, a lucrative opportunity emerged of providing equipment financing supplementing the high market demand for forestry and equipment.The year 1951 was a year of opportunities where the company bought an equipment manufacturing firm. Consequently, the company suspended the funding of other equipment brands due to the increased manufacturing, selling, and financing its brand of forestry and building equipment.
On the other hand, Will Bury started as a mere worker at the High Tech Digital Industries, where he gathered necessary innovations skills to start his music and digital business.In the garage operation, Will increased his knowledge and entrepreneurship culture to prompt the decision of starting the digital book enterprise that he invented. Will Burry was faced with many dilemmas of how to ascertain his technological application, which kind of clientele to serve, the way of distribution of the services to the people, the demand for books, as well as the pricing strategies.
Monopolistic competition markets structure
As per the two scenarios of Will Bury and Thomas Money Services, it is crystal clear that they are examples of monopolistic market structures. This form of a market is a blend of the monopoly and perfect competition and has been called monopolistic competition or competing monopolists as stated by (Hushke, 2010). In the real world, there is neither absolute monopoly that is an absence of competition, nor perfect competition, but monopolistic competition. The products are not complete substitutes for one another, but they are close substitutes.
With respect to monopolistic competition, the number of dealers (buyers and sellers) is not large, at any rate not as lar.
Mergers & Acquisition (Return Of The Big Deal!)André Harrell
After years of stagnant activity, mergers and acqui- sitions surged in 2014, with the announcement
of more than 7,500 deals1 with a combined value exceeding $3.5 trillion. That’s an increase of more than 7 percent by number and more than 25 percent by value compared with 2013. While
that volume hasn’t yet reached the high of nearly 10,000 deals set in 2007, a new wave of activity
is clearly under way.
Factors affecting Suppliers’ Refusal to Participate in Public procurement thr...IJAEMSJORNAL
This study identified factors of the procurement process and policies that affected suppliers’ decisions to refuse to participate in public procurement. The assessment of discernment is in the extent of suppliers’ company profiles and the procurement process and policies based on the 2016 Revised Implementing Rules and Regulations of Republic Act 9184. The study used a descriptive research design. A simple random sampling method was used to selected participants for the study. A combination of a checklist, free and scaled response questionnaire was used to collect responses. The researchers were able to disseminate questionnaires to the suppliers of different government agencies in the vicinity of the Science City of Muñoz, Nueva Ecija. The study revealed that a huge number of the surveyed suppliers felt that participation in public procurement through a competitive bidding process would entail them with more obstacles and challenges than some alternative types of procurement. The study also found that the three most-cited factors affecting suppliers’ decisions to refuse in participating: the approved budget for the contract is usually too low, the time frame for the delivery is usually too short, and the process is too long.
The study seeks to contribute to the discussion on the causes of maverick buying-
MB and its impact on the procurement policy and the economy of Ghana in general. The
research methodology used in this study is qualitative. The instrument of study was based on
non standard interview with the officers that are experts on the topic at the district assemblies
where 11 districts assemblies were covered out of 22. The study revealed the following causes;
procurement practitioners find it difficult to understand the Procurement Act 663, practitioners
lack capacity both academically and professionally in the management and operationalisation
of the procurement process, the Procurement Act 663 is excessively legalistic and technical,
the Act 663 is at anomalous with market trends or practices. The study also found out that there
are lapses in monitoring for compliance of the Procurement Act 663, no examples of known
procurement practitioners punished for non compliance, lack of commitment on the part of
officialdom, organisational culture at the district level a major cause of maverick buying and
most of the procurement activities are unplanned. On the impact, the study established that MB
defeats the superseding objectives of the Public Procurement Act 663 of 2003, it is also
insidious to the aptitude to negotiate favourable terms for price of goods, services and works
due to the crumbling of spend, MB had the ability to deny the assemblies the knack to collect
data on the assemblies’ sequence of purchasing or spending thereby causing the assemblies to
lose visibility over its outlay, it also increases purchasing cost where it affects equally the
actual purchasing price and process cost, it was also disclosed that fraud and corruption can
ensue from MB. The study recommends that PPA and the ministry of education should link up
to train procurement practitioners as stipulated in Procurement Act 663 section 3(k) to improve
the awareness and knowledge of procurement processes at the district assemblies and the
nation in general. Monitoring compliance trends should also be a key part of the Public
Procurement Authority-PPA. As a matter of fact the institution responsible for sanction should
be incorporated into the enforcement unit for swift punishment to act as deterrence to others.
PPA and the districts should link up on how eProcurement systems can be implemented to
ensure compliance since the most commonly declare solution for maverick buying is the
implementation of electronic procurement.
This presentation by Ms. Jyoti Jindgar Bhanot was made at the workshop on Competition in Publicly Funded Markets (28 February 2019). Find out more at http://www.oecd.org/daf/competition/workshop-on-competition-in-publicly-funded-markets.htm
This presentation by Susan F. STONE, Head, Emerging Policy Division, Trade and Agriculture Directorate, OECD, was made during the discussion “Competition provisions in trade agreements” held at the 18th meeting of the OECD Global Forum on Competition on 5 December 2019. More papers and presentations on the topic can be found at oe.cd/cpta.
On 31 October 2019, Adrian Towse and Chris Henshall from the Office of Health Economics (OHE) presented at the G20 meeting on antimicrobial drugs R&D in Paris organised by the Wellcome Trust. The topic of their presentation was HTA and payment mechanisms for new drugs to tackle antimicrobial resistance.
This presentation looks at ways in which governments can set prices, including “cost plus”, value, and the external referencing of prices elsewhere. It looks at the role that competition can play in keeping down prices. In that context it briefly discusses pricing proposals being considered in Malaysia. It makes the case for using HTA to inform pricing decisions.
Adrian Towse
% GDP spending in UK, G5 countries and OECD upper middle income countries. W...Office of Health Economics
This presentation looks at rates of GDP spend on health care, distinguishing between categories of country (i.e. levels of GDP pre capita). It looks at the relationship between rates of spending and moves to universal health coverage, and explores alternative ways of increasing expenditure and making decisions about which services to provide with the money available.
The role of real world data and evidence in building a sustainable & efficien...Office of Health Economics
This presentation defines RWD and RWE in the context of digital health, and looks at potential uses for RWD and RWE. It briefly sets out the current landscape in Malaysia and looks at the challenges in using RWE. In particular, the issues of access, governance and ensuring good quality are considered.
The aim of this educational symposium was to discuss why we should seek value across the health care system and how we can apply existing research methods to measure the value of services. While considerable political attention in developed countries continues to be focused on drug spending, there is also growing awareness of the significant contribution of non-drug components of health care (e.g., hospital services and inefficient care delivery) to overall spending growth and patient affordability. At the same time, there is growing interest in making greater use of value assessment and value-based payment to control spending and better align it with care quality. In order to promote greater value, and to do so in ways that respond to the needs of payers and patients, it is essential to assess value across both drug- and non-drug interventions and health care services. This panel will offer expert viewpoints to identify and discuss gaps in value information, rationale and approaches to track and reduce system-wide low value care, and research methods for how to measure health care services.
Role Substitution, Skill Mix, and Provider Efficiency and Effectiveness : Les...Office of Health Economics
Graham participated in an organised session on Monday July 15th 2019. In the session he presented his paper with his co-author Ioannis Laliotis from the London School of Economics. The paper revisits the relationship between workforce and maternity outcomes in the English NHS in an attempt to contribute knowledge to an important policy question for which there has been a paucity of research.
This research explores the feasibility of introducing an Outcome-Based Payment approach for new cancer drugs in England. A literature review explored the current funding landscape in England, the available evidence on existing OBP schemes internationally, and
which outcomes cancer patients value most. Two focus groups and an online survey with patients and carers, as well as interviews with NHS and government stakeholders, healthcare
professionals, and pharmaceutical industry representatives, provided additional evidence on the feasibility and suitability of OBP schemes
Understanding what aspects of health and quality of life are important to peopleOffice of Health Economics
Poster presentation from the EuroQol Plenary Meeting 2019, Brussels, Belgium. By Koonal Shah, Brendan Mulhern, Patricia Cubi-Molla, Bas Janssen, and David Mott.
Koonal presented as part of an organised session on ‘moving beyond conventional economic approaches in palliative and end of life care’. He summarised the empirical evidence on the extent of pubic support for an end of life premium, before discussing some novel approaches that have been used in recent studies. His presentation was discussed by Helen Mason of Glasgow Caledonian University.
Author(s) and affiliation(s): Koonal Shah, Office of Health Economics
Event: iHEA Congress
Date: 17/07/2019
Location: Basel, Switzerland
Assessing the Life-Cycle Value Added of Second Generation Antipsychotics in S...Office of Health Economics
This research presented in a poster at HTAi 2019, Cologne (Germany) by a team of OHE and IHE researchers, estimates the value added by second generation antipsychotics over their life-cycle in the UK and Sweden. It concludes that considering the entire life-cycle, the value added by SGAs to the system is higher than the expected value estimated at launch. P&R decisions should consider how to measure, capture and take into account the value added by medicines over the long-run.
Author(s) and affiliation(s): Mikel Berdud (Office of Health Economics, London), Niklas Wallin-Bernhardsson (Institute for Health Economics, Stockholm), Bernarda Zamora (Office of Health Economics, London), Peter Lindgren (Institute for Health Economics, Stockholm), Adrian Towse (Office of Health Economics, London)
Event: HTAi 2019 Annual Meeting
Date: 18/06/2019
Location: Cologne, Germany
There is growing recognition that HTA and contracting systems for antimicrobials need to be adapted to help fight the threat of antimicrobial resistance (AMR), but there is little agreement on how. This poster reports findings from a literature review, expert interviews and face-to-face discussions at a Forum on the current HTA and payment systems for antibiotics across Europe and a number of recommendations for adapting these systems to respond to the challenges of AMR.
Author(s) and affiliation(s): Margherita Neri (OHE) Grace Hampson (OHE) Christopher Henshall (OHE visiting fellow, independent consultant) Adrian Towse (OHE)
Event: HTAi annual conference 2019
Date: 18/06/2019
Location: Cologne, Germany
Assessing the Life-cycle Value Added of Second-Generation Antipsychotics in S...Office of Health Economics
This study aims to guide access decisions and drive the discussion on access and price, through recognition of the dynamic nature of value added by pharmaceutical innovation over the long-run. The analysis of the life-cycle value of risperidone estimates the value generated in the UK and Sweden. Results show that health systems were able to appropriate most of the life-cycle value generated, and this is larger than estimated at launch.
Author(s) and affiliation(s): Mikel Berdud(1), Niklas Wallin-Bernhardsson(2), Bernarda Zamora(1), Peter Lindgren(2), and Adrian Towse(1) (1) Office of Health Economics (2) The Swedish Institute for. Health Economics
Event: XXXIX JORNADAS DE ECONOMÍA DE LA SALUD
Date: 12/06/2019
Location: Albacete, Spain
Prescribed Specialised Services (PSS) Commissioning for Quality and Innovation (CQUIN) schemes were launched in 2013 in England with the aim of improving the quality of specialised care and achieving value for money. During this presentation, Marina Rodes Sanchez described the key features of the schemes and discussed its strengths and weaknesses based on international pay-for-performance literature.
Author(s) and affiliation(s): Yan Feng, Queen Mary University of London; Søren Rud Kristensen, Imperial College London; Paula Lorgelly, King’s College London; Rachel Meacock, University of Manchester; Marina Rodes Sanchez, Office of Health Economics; Luigi Siciliani, University of York; Matt Sutton, University of Manchester
Event: XXXIX Spanish Health Economics Association Conference
Date: 12/06/2019
Location: Albacete, Spain
In this session, Meng Li sets out estimates of real option value for drugs arguing that option value matters and can be calculated. Adrian Towse sets out likely payer concerns about incorporating real option value into decision making. Meng Li responds to these concerns. Jens Grueger sets out how industry considers investment opportunities, arguing that if patients (and society) have preferences these need to be reflected in P&R decisions.
Author(s) and affiliation(s): Meng Li, Postdoctoral Research Fellow, Leonard D Schaeffer Center, University of Southern California, Los Angeles, CA, USA. Adrian Towse, Emeritus Director, Office of Health Economics, London, UK Jens Grueger, formerly Head of Global Access, Senior Vice President at F. Hoffmann-La Roche
Event: ISPOR 2019
Location: New Orleans, USA
Date: 21/05/2019
MCDA OR WEIGHTED CEA BASED ON THE QALY? WHICH IS THE FUTURE FOR HTA DECISION ...Office of Health Economics
In this ISPOR session Chuck Phelps and Adrian Towse debated the case for and against using MCDA to support HTA decision making, as compared to weighting or augmenting a QALY based ICER approach. Chuck Phelps argued for use of MCDA, Adrian Towse for weighting the QALY. Nancy Devlin set the scene and moderated.
Author(s) and affiliation(s): Nancy Devlin, Director, Centre for Health Policy, University of Melbourne, Australia Adrian Towse, Emeritus Director, Office of Health Economics, London, UK Chuck Phelps, University of Rochester, Rochester, NY USA
Event: ISPOR 2019
Location: New Orleans, USA
Date: 21/05/2019
The issue of open-source models in the cost-effectiveness and disease-level (collaborative) models has been brewing for many years. There has been a marked growth in open science, and funding bodies and publishers increasingly require that research data be made available. As mentioned in our previous Issue Panel, “cost-effectiveness models synthesise a wide range of evidence to facilitate extrapolation over time and from intermediate to final decision endpoints. These models are often statistically sophisticated and require assumptions that are not directly testable. This can lead to decision-makers “discounting” the results of cost-effectiveness analyses, particularly if the developer is seen as partial.” Open-source models, then, would encourage greater transparency in pharmacoeconomic modeling and the reuse and updating of the best/most useful models; they are essential if cost-effectiveness analyses are to be widely accepted to reduce bias, increase transparency, improve model access, and allow for faster access to critical knowledge. The ISPOR-SMDM guidelines and the EUnetHTA joint action projects, are supportive of these views on collaboration, transparency, confidentiality, processes and consistency offered by the availability of open-source models to improve decision-making around health care and reimbursement. With openness and sharing, however, come issues of copyright and access and a need to define how model sharing can be achieved in a fair and equitable manner. There is, therefore, a need to develop an ongoing dialog on openness, especially where the research may be considered precompetitive and not worthy of IP investment. The pros and cons of open source models and the proposed mission of the Open Source Model SIG to curate an ongoing dialog regarding issues around creating, disseminating, sharing, evaluating, and updating open source cost-effectiveness and comparative effectiveness models will be debated amongst SIG members.
Author(s) and affiliation(s): Nancy Risebrough, Senior Principal, ICON plc, Toronto, Canada Jeroen P Jansen; Innovation & Value Initiative; Precision Medicine Group; and Stanford University Lotte Steuten, Vice President & Head of Consulting, Office of Health Economics, UK Renée JG Arnold, PharmD, RPh, ICON plc, New York, NY and Icahn School of Medicine at Mount Sinai, New York, NY, USA
Event: ISPOR 2019 Annual Meeting
Date: 20/05/2019
how to swap pi coins to foreign currency withdrawable.DOT TECH
As of my last update, Pi is still in the testing phase and is not tradable on any exchanges.
However, Pi Network has announced plans to launch its Testnet and Mainnet in the future, which may include listing Pi on exchanges.
The current method for selling pi coins involves exchanging them with a pi vendor who purchases pi coins for investment reasons.
If you want to sell your pi coins, reach out to a pi vendor and sell them to anyone looking to sell pi coins from any country around the globe.
Below is the contact information for my personal pi vendor.
Telegram: @Pi_vendor_247
how to sell pi coins in all Africa Countries.DOT TECH
Yes. You can sell your pi network for other cryptocurrencies like Bitcoin, usdt , Ethereum and other currencies And this is done easily with the help from a pi merchant.
What is a pi merchant ?
Since pi is not launched yet in any exchange. The only way you can sell right now is through merchants.
A verified Pi merchant is someone who buys pi network coins from miners and resell them to investors looking forward to hold massive quantities of pi coins before mainnet launch in 2026.
I will leave the telegram contact of my personal pi merchant to trade with.
@Pi_vendor_247
how to sell pi coins on Bitmart crypto exchangeDOT TECH
Yes. Pi network coins can be exchanged but not on bitmart exchange. Because pi network is still in the enclosed mainnet. The only way pioneers are able to trade pi coins is by reselling the pi coins to pi verified merchants.
A verified merchant is someone who buys pi network coins and resell it to exchanges looking forward to hold till mainnet launch.
I will leave the telegram contact of my personal pi merchant to trade with.
@Pi_vendor_247
Financial Assets: Debit vs Equity Securities.pptxWrito-Finance
financial assets represent claim for future benefit or cash. Financial assets are formed by establishing contracts between participants. These financial assets are used for collection of huge amounts of money for business purposes.
Two major Types: Debt Securities and Equity Securities.
Debt Securities are Also known as fixed-income securities or instruments. The type of assets is formed by establishing contracts between investor and issuer of the asset.
• The first type of Debit securities is BONDS. Bonds are issued by corporations and government (both local and national government).
• The second important type of Debit security is NOTES. Apart from similarities associated with notes and bonds, notes have shorter term maturity.
• The 3rd important type of Debit security is TRESURY BILLS. These securities have short-term ranging from three months, six months, and one year. Issuer of such securities are governments.
• Above discussed debit securities are mostly issued by governments and corporations. CERTIFICATE OF DEPOSITS CDs are issued by Banks and Financial Institutions. Risk factor associated with CDs gets reduced when issued by reputable institutions or Banks.
Following are the risk attached with debt securities: Credit risk, interest rate risk and currency risk
There are no fixed maturity dates in such securities, and asset’s value is determined by company’s performance. There are two major types of equity securities: common stock and preferred stock.
Common Stock: These are simple equity securities and bear no complexities which the preferred stock bears. Holders of such securities or instrument have the voting rights when it comes to select the company’s board of director or the business decisions to be made.
Preferred Stock: Preferred stocks are sometime referred to as hybrid securities, because it contains elements of both debit security and equity security. Preferred stock confers ownership rights to security holder that is why it is equity instrument
<a href="https://www.writofinance.com/equity-securities-features-types-risk/" >Equity securities </a> as a whole is used for capital funding for companies. Companies have multiple expenses to cover. Potential growth of company is required in competitive market. So, these securities are used for capital generation, and then uses it for company’s growth.
Concluding remarks
Both are employed in business. Businesses are often established through debit securities, then what is the need for equity securities. Companies have to cover multiple expenses and expansion of business. They can also use equity instruments for repayment of debits. So, there are multiple uses for securities. As an investor, you need tools for analysis. Investment decisions are made by carefully analyzing the market. For better analysis of the stock market, investors often employ financial analysis of companies.
Empowering the Unbanked: The Vital Role of NBFCs in Promoting Financial Inclu...Vighnesh Shashtri
In India, financial inclusion remains a critical challenge, with a significant portion of the population still unbanked. Non-Banking Financial Companies (NBFCs) have emerged as key players in bridging this gap by providing financial services to those often overlooked by traditional banking institutions. This article delves into how NBFCs are fostering financial inclusion and empowering the unbanked.
how to sell pi coins at high rate quickly.DOT TECH
Where can I sell my pi coins at a high rate.
Pi is not launched yet on any exchange. But one can easily sell his or her pi coins to investors who want to hold pi till mainnet launch.
This means crypto whales want to hold pi. And you can get a good rate for selling pi to them. I will leave the telegram contact of my personal pi vendor below.
A vendor is someone who buys from a miner and resell it to a holder or crypto whale.
Here is the telegram contact of my vendor:
@Pi_vendor_247
how to sell pi coins in South Korea profitably.DOT TECH
Yes. You can sell your pi network coins in South Korea or any other country, by finding a verified pi merchant
What is a verified pi merchant?
Since pi network is not launched yet on any exchange, the only way you can sell pi coins is by selling to a verified pi merchant, and this is because pi network is not launched yet on any exchange and no pre-sale or ico offerings Is done on pi.
Since there is no pre-sale, the only way exchanges can get pi is by buying from miners. So a pi merchant facilitates these transactions by acting as a bridge for both transactions.
How can i find a pi vendor/merchant?
Well for those who haven't traded with a pi merchant or who don't already have one. I will leave the telegram id of my personal pi merchant who i trade pi with.
Tele gram: @Pi_vendor_247
#pi #sell #nigeria #pinetwork #picoins #sellpi #Nigerian #tradepi #pinetworkcoins #sellmypi
Introduction to Indian Financial System ()Avanish Goel
The financial system of a country is an important tool for economic development of the country, as it helps in creation of wealth by linking savings with investments.
It facilitates the flow of funds form the households (savers) to business firms (investors) to aid in wealth creation and development of both the parties
What price will pi network be listed on exchangesDOT TECH
The rate at which pi will be listed is practically unknown. But due to speculations surrounding it the predicted rate is tends to be from 30$ — 50$.
So if you are interested in selling your pi network coins at a high rate tho. Or you can't wait till the mainnet launch in 2026. You can easily trade your pi coins with a merchant.
A merchant is someone who buys pi coins from miners and resell them to Investors looking forward to hold massive quantities till mainnet launch.
I will leave the telegram contact of my personal pi vendor to trade with.
@Pi_vendor_247
Exploring Abhay Bhutada’s Views After Poonawalla Fincorp’s Collaboration With...beulahfernandes8
The financial landscape in India has witnessed a significant development with the recent collaboration between Poonawalla Fincorp and IndusInd Bank.
The launch of the co-branded credit card, the IndusInd Bank Poonawalla Fincorp eLITE RuPay Platinum Credit Card, marks a major milestone for both entities.
This strategic move aims to redefine and elevate the banking experience for customers.
Falcon stands out as a top-tier P2P Invoice Discounting platform in India, bridging esteemed blue-chip companies and eager investors. Our goal is to transform the investment landscape in India by establishing a comprehensive destination for borrowers and investors with diverse profiles and needs, all while minimizing risk. What sets Falcon apart is the elimination of intermediaries such as commercial banks and depository institutions, allowing investors to enjoy higher yields.
How to get verified on Coinbase Account?_.docxBuy bitget
t's important to note that buying verified Coinbase accounts is not recommended and may violate Coinbase's terms of service. Instead of searching to "buy verified Coinbase accounts," follow the proper steps to verify your own account to ensure compliance and security.
The European Unemployment Puzzle: implications from population agingGRAPE
We study the link between the evolving age structure of the working population and unemployment. We build a large new Keynesian OLG model with a realistic age structure, labor market frictions, sticky prices, and aggregate shocks. Once calibrated to the European economy, we quantify the extent to which demographic changes over the last three decades have contributed to the decline of the unemployment rate. Our findings yield important implications for the future evolution of unemployment given the anticipated further aging of the working population in Europe. We also quantify the implications for optimal monetary policy: lowering inflation volatility becomes less costly in terms of GDP and unemployment volatility, which hints that optimal monetary policy may be more hawkish in an aging society. Finally, our results also propose a partial reversal of the European-US unemployment puzzle due to the fact that the share of young workers is expected to remain robust in the US.
1. CGD Seminar 10th February 2020
Price
Transparency:
good or bad?
What does the
literature and
theory tell us?
2. CGD Seminar 10th February 2020
●Transparency of which price?
●Price transparency as a good in itself, or as a means to achieve the
end of better health care?
●Transparency of process of establishing prices
●Price transparency and collusion
●Does price transparency improve outcomes?
●On-patent medicines
●Off-patent medicines
●Conclusions: four questions and some recommendations
5. CGD Seminar 10th February 2020
●I focus on the price paid by third party payers
●And the price paid to the manufacturers – at the factory gate.
●I distinguish between the price of off-patent (generics and biosimilars)
and the price of on-patent drugs
●I also briefly discuss the challenges faced by patients buying out-of-
pocket
6. CGD Seminar 10th February 2020
●Is transparency:
(i) a good thing in itself (i.e., should we be open in what we do?); or
(ii) a means to the end of more cost-effective procurement, and greater
health gain.
●The first point is not an economic issue but a preference that a society
may or may not have.
●Most transparency advocates think (i) leads to (ii)
●What if there is a trade-off? More transparency reduces health gain?
●Where would you sit on that trade-off?
7. CGD Seminar 10th February 2020
●Clear distinction between transparency of procurement process and
transparency of the prices obtained from that process.
●By process transparency I include not only the rules which aim to
prevent opaque and discretionary procurement practices, but also the
transparency of preliminary results inside the procurement process, in
other words, the degree of information revealed throughout the tender
process
8. CGD Seminar 10th February 2020
●Corruption increases the prices paid by public bodies e.g. Di Tella and
Schargrodsky (2003), Buenos Aires hospital prices went down 10% as a
result of a crackdown.
●Corruption can be:
●capture (firm bribes a public official) – “active” bribery (OECD)
●or extortion (official demands a bribe to participate) – a “facilitation
payment” (OECD)
● Auriol (2006) estimates loss from capture as 4-10% of global
procurement spending
9. CGD Seminar 10th February 2020
●Transparency of process can also improve competition:
●Opaque and discretionary procurement practices reduce incentives for firms to enter the market
and actively pursue new contracts
●Ohashi (2009) found improved transparency in the bidder qualification process in Japan enhanced
competition and reduced government expenditure. Suppliers bid more aggressively under a
transparent process than under a discretionary one.
●Bulow and Klemperer (1994) show that process transparency in the form of auctions increases
competition
●In Chile, Singer et al., (2009) showed how electronic procurement (e-procurement) resulted in price
savings by increasing the number of serious bidders
●Lewis-Faupel et al. (2016) found that e-procurement increased the probability that the winning
bidder comes from outside the region granting the contract.
10. CGD Seminar 10th February 2020
●Surely the extra information provided by price transparency will expose obvious
issues of corruption, negligence, or inefficiency?
●In the extreme, even if price transparency linked markets in a way that made new
entrants less willing to offer low prices, the elimination of corruption could mean
that prices were still lower than with non-disclosure?
●There are likely however to be a number of ways of exposing or tackling corruption
without disclosing prices publicly (Søreide, 2002).
●It makes more sense to separate policy mechanisms to tackle corruption from
those for getting good value from a non-corrupt procurement process.
11. CGD Seminar 10th February 2020
●Organization of the process is costly. Costs can outweigh benefits
●Although this is unlikely
●For nonstandard complex transactions, the use of simple transparent auctions
may prevent the exchange of important precontract information, risking less
informed bids leading to higher prices, lower quality performance, or non-viable
bids
●With negotiation, the buyer usually discusses the project in detail with the seller
before the contract is signed, reducing the likelihood of uninformed bids
●If quality is unverifiable, auctions provide high-powered incentives for price
reduction at the expense of quality
●The optimal degree of process transparency is not clear as making too much
information available to bidders during the process can facilitate collusion
12. CGD Seminar 10th February 2020
●Extent of revelation of information during the auction (i.e. in intermediate rounds within an
ascending auction) affects bidders' bidding behaviour. The revelation of information after the
auction affects bidders’ behaviour in future auctions
●The analysis of collusion in modern industrial economics is based on exploring incentives and
constraints for collusion.
●The OECD guidelines for public procurement states that “disclosing information such as the identity
of the bidders and the terms and conditions of each bid allow competitors to detect deviations from
a collusive agreement, punish those firms and better coordinate future tenders” (OECD, 2008).
●If prices are fully transparent, then firms have more tools to maintain collusion given that it is easier
for the rivals to detect any deviation.
●Stigler (1964) argued that collusive agreements were more likely with homogeneous commodities
but would break down if price cuts are secret or non-observable, i.e. the agreement cannot be
policed.
13. CGD Seminar 10th February 2020
●The existence of confidential discounts makes list prices unreliable, and sellers lose confidence in
rivals’ willingness to cooperate (Scherer, 1997; Schultz, 2005; Tetteh, 2009).
●An OECD report on corruption and collusion in public procurement (OECD, 2010) concludes:
●“The principle of transparency – which relates to the availability of information on contract
opportunities, the rules of the process, decision-making and verification and enforcement – is of
critical importance in preventing corruption.”
●“In certain instances, however, transparency is inconsistent with the need to ensure maximum
competition within the procurement process.”
●“Transparency requirements can result in unnecessary dissemination of commercially sensitive
information, allowing firms to align their bidding strategies and thereby facilitating the formation
and monitoring of bid rigging cartels.”
●“Transparency may also make a procurement procedure predictable, which can further assist
collusion.”
14. CGD Seminar 10th February 2020
●Albæk, Møllgaard, and Overgaard (1997) studied a 1993 case. The Danish antitrust
authority published firm-specific transactions prices for two grades of ready-mixed
concrete in three regions. Average prices increased by 15-20 percent within one
year and prices converged across firms serving the same market. Publication
allowed firms to reduce price competition and, hence, led to increased prices.
●Cason, Kannan, and Siebert (2011) used a laboratory experiment to show the effect
of coordination in procurement auctions.
●Further evidence that price transparency increases collusion risk from Bergemann
and Hörner (2018), albeit looking at a market of many buyers and one seller.
●Recent US generic cases ….
15. CGD Seminar 10th February 2020
● Many argue (Morgan, Vogler, and Wagner, 2017; Vogler and Paterson, 2017) that price transparency might be good:
● as a piece of information to assess the efficiency of a procurement process, [how am I doing?] but also
● as an input to that process. Knowing what others had paid would facilitate negotiations with pharmaceutical firms, who
were, of course, well aware of the prices they had agreed with other payers.
● Vogler and Paterson (2017) oppose the use of confidential discounts as a way to achieve price discrimination and
affordable patient access to medicines. They argue that price transparency can better contribute to this aim. The authors
want partners in negotiation to meet on equal terms to avoid an imbalance caused by information asymmetry that weakens
the purchasing power of the procurers. They argue that the acceptance of confidential discounts creates negative
externalities, impacting procurement and price negotiation in other health systems, and hampering cooperation among
countries that could ultimately benefit all payers in the long term.
● This is reflected in the WHO Report. Better information on prices in other countries to improve their ability to control the
prices of their own reimbursed prescription drugs through either international reference pricing (IRP) or direct negotiation
(Hill, Barber, & Gotham, 2018).
● Need to separate
● on-patent innovative drugs; and
● off-patent drugs which are often multi-source supplied
16. CGD Seminar 10th February 2020
●Price transparency makes international price comparisons easier,
producing more price uniformity across countries
●This is also the case with reference pricing or parallel trade.
●In some industries, price comparisons across countries are particularly
useful, because they induce competition among firms promoting what
is called static efficiency.
●This is the logic behind trade agreements including the move of the
European Union to create a Single Market for goods and services.
17. CGD Seminar 10th February 2020
●Static efficiency: the most efficient use of existing resources:
●For any given level of production, competition reduces mark-ups, setting prices
closer or equal to the marginal cost of production. Competition helps to achieve
productive efficiency, the good is produced with an optimal combination of inputs
at the lowest possible cost.
● But it also helps to achieve allocative efficiency, where resources are efficiently
distributed between their best uses as far as consumers are concerned. This is
the first-best solution.
●For the innovative pharmaceutical industry, with large fixed R&D costs, achieving
first best static efficiency jeopardises sustainability. When prices are equal to
short-run marginal costs the industry cannot recover sunk fixed R&D costs.
18. CGD Seminar 10th February 2020
●Patents allow prices to be set above marginal cost of production for the period of protection, and so
allow firms to recover R&D costs and achieve dynamic efficiency.
●Differential pricing based on Ramsey pricing has been seen as the second-best solution. It
guarantees dynamic efficiency by enabling developers to recoup the costs of R&D, while minimises
the damage caused to the static efficiency by setting prices above the marginal cost
●Danzon, Towse, and Mestre‐Ferrandiz (2015) demonstrated that second-best static efficiency and
dynamic efficiency were achieved when each payer set a willingness to pay threshold for buying
pharmaceuticals that reflected the preferences for health gain of those they were buying for, given
the relevant budget constraint and other competing demands on that budget, and permitted firms to
price up to that threshold.
●Of course, price discrimination, as compared to uniform pricing, typically harms some consumers
but benefits others. Countries facing relatively high prices under international price discrimination
tend to ignore the gains to consumers in low-price countries when they reference price for their own
market.
19. CGD Seminar 10th February 2020
●Achieving dynamic efficiency is not an issue in generics markets. Patents have
expired and should have ensured rewards to innovators.
●Static efficiency should be the concern for maximizing social welfare under
generic competition. Price transparency is a good instrument to attain this
objective, both when purchasing is by third party payers and by patients paying out-
of-pocket.
●Two provisos:
●The need to avoid collusion;
●The issue of unobserved quality. In countries where most drugs are purchased by
patients out-of-pocket and quality assurance regulation is unreliable, price
transparency might have unintended consequences when products are quality
differentiated in a way that is hard for buyers to assess ex ante.
20. CGD Seminar 10th February 2020
● Price transparency links markets.
● If buyer A is likely to insist on the same or a better price than that paid by buyer B, then the supplier will adjust
their price in market B accordingly. If the markets are significantly different, and market B is much poorer, then
B may end up not being supplied.
● The optimal solution for the company is to supply both A and B but at very different prices. This is also in the
interest of B, but not in the short run (static efficiency) interests of A if (and only if) the supplier is willing to offer
A lower prices because it is still worth supplying country B.
● Supplier is likely to delay launch or not launch at all in market B if this means they must forego the price
premium in market A.
● In the long run, if A pays prices for health gain that are below its ability to pay given its healthcare budget
allocation, then suboptimal levels of innovation may occur to the detriment of its citizens (i.e., there will be a
loss of dynamic efficiency.)
● If buyer A accepts that market B should pay a lower price, then disclosure does not directly link markets.
However, it is hard to see the point of price transparency in these circumstances. Markets are linked, but in a
way agreed and accepted by buyers. Reaching such an agreed structure is likely to be difficult.
21. CGD Seminar 10th February 2020
● We need to separate the role of price transparency from that of increased buyer bargaining power
● If buyers A and B combine forces to offer a higher volume, then the price is likely to be lower than the price in market A.
● However, it may still not be lower than that which would have been offered to payer B in the absence price transparency.
● On the other hand, smaller markets less attractive to a supplier may suffer from either disproportionate (given their wealth
levels) prices or no supply. In such a case, a small country joining a purchasing group with a large wealthier market may
result in access and a better price than the former could have secured on its own.
● Bargaining power comes from purchasing large volumes, but also from not having any more money to put on the table
● PAHO is a powerful and effective vaccine purchaser. PAHO publishes its vaccine prices on-line. It is a sufficiently powerful
purchaser to be able to insist that it is offered the lowest price a supplier will offer anywhere in the world.
● Might some lower income countries get a better deal outside of PAHO, if PAHO did not insist on lowest price?.
● It depends on the costs of supplying the country (i.e. of doing business in the country) and how much lower the price could
go relative to marginal cost, and whether in practice companies would be willing to supply at a lower price, if they didn’t have
to offer the same price to Brazil and other large middle income PAHO members.
● It is not clear to us, however, that price transparency, as opposed to bargaining power, helps PAHO get a low price. PAHO
may get a good deal in spite of price transparency and not because of it.
22. CGD Seminar 10th February 2020
●Cernuschi et al. find 4 countries using data for price
negotiations and 3 for purchase which “led to changes in
practices that have reduced costs such as earlier ordering
and pooled procurement..”
●Colbert et al. “Transparency is a key element to determine
what is [a fair price] but there is an absence of reliable data
on development costs…Ultimately there is no simple
algorithm that will calculate a fair price for each medicine. “
●Moon et al. sees a fair price as somewhere between
sustainable cost (including R&D) and “a maximum
affordable price” “Costs may be discovered ..by prices
under competitive market conditions or estimated by
experts using prices of inputs.” Need to “allocat[e] global
R&D costs across countries or buyers, and incorporat[e]
value assessments into the price.”
23. CGD Seminar 10th February 2020
●Differential pricing is not needed for dynamic efficiency
●There is no reason for ex-manufacturer prices to vary by market other
than to reflect differences of the “in market” costs of doing business in
a particular country or region.
●There is therefore a stronger case for price transparency for generics,
albeit with the proviso of the need to avoid collusion.
●One major reason why off-patent prices do vary within and between
MLICs is because of differences in real and perceived quality. The way
to increase price competition is to raise quality. This can be most
readily accomplished by improving medicines regulation
24. CGD Seminar 10th February 2020
●Theory suggests that repeat purchases of homogenous products creates the
circumstances for cartels and for tacit collusion
●Price transparency increases the opportunity for collusion by enabling colluders to
observe “deviant” behaviour on the part of fellow suppliers
●One route forward is to have one-sided disclosure of multi-source prices, i.e.
between buyers alone.
●This offers potential benefits of increased competition, with buyers better
understanding what is on offer, whilst avoiding suppliers more easily colluding
●Ensuring no supplier access would be important. If some suppliers were to obtain
access to these prices (via sympathetic buyers or through corrupt payments), this
would influence how those suppliers behaved.
25. CGD Seminar 10th February 2020
●A major reason for relatively high prices for medicines in retail pharmacies in many MLICs is the
inefficiency of mark-ups in the distributor and retail sector.
●Transparency of distributor, retailer, and tax mark-ups can be helpful (though much more context
sensitive than product prices) because it enables governments to understand the efficiency of the
supply chain beyond the ex-factory price.
●Margin disclosure could lead to collusion, but given that the final retail prices are, by definition,
transparent, this less likely.
● Where governments contract for distribution services to deliver drugs and vaccines to hospitals
and clinics, the main factor impacting the efficiency of the price obtained is likely to be the
transparency of the procurement process.
●However, it is important that the scale of added cost is understood.
●If government distribution contracts are “winner takes all” and come about only every few years,
then the opportunities for collusion from price transparency are limited.