Price Comparisons

Contents 1 INTRODUCTION 1 2 GENERAL PRINCIPLES FOR MEASURING PRICE DIFFERENCES FOR PHARMACEUTICALS 5 3 THE U.S RETAIL PRICE VERSUS FSS BEST PRICE COMPARISON 13 4 COMPARISONS WITH CANADA AND MEXICO 27 5 THE GROWTH OF PRICE DISCOUNTING IN HEALTH CARE 35 6 POLICY IMPLICATIONS 43 NOTES 47 REFERENCES 51 ABOUT THE AUTHOR 55 v Introduction S everal recent studies have had as their purpose "to determine whether pharmaceutical manufacturers are taking advantage of older Americans through price discrimination and, if so, whether this is part of the explanation for the high drug prices being paid by older Americans." The domestic variant of these studies attempts to measure price differentials for pharmaceuticals between cash-paying customers and large health maintenance organizations in the United States. The international studies compare pharmaceutical prices paid by retail customers in the United States with those paid in Canada and Mexico. Specifically, the studies collected data

Responsible Tax Credits

Contents FOREWORD Robert B. Helms vii 1INTRODUCTION 1 The Voucher and Credit Approach 1 The Purpose of This Study 3 2CHANGES IN ATTITUDES ABOUT HEALTH ISSUES 4 New Realism 4 New Alliances 6 Less Concern over Cost 6 Demand for More Choice 8 3CHANGES IN THE ECONOMIC ENVIRONMENT FOR HEALTH CARE 9 New Success in Cost Containment 9 The Federal Budget 10 Changes in Purchasing Insurance 10 Political Changes 12 4DESIGN ISSUES 13 Ta r get Populations 13 Preliminaries 15 A Possible Structure 16 5TWO DIFFERENT GROUPS FOR THE CREDIT 21 Value of Credit for the Uninsured 21 Value of Credit for the Insured 22 6POLICY TRADE-OFFS 24 A Simplified and Adaptive Tax-Credit Plan 24 The Simplest Program 24 Fitted with Exclusion 25 Adjusted for Income 26 Affordability and Need 27 VI CONTENTS 7TECHNICAL DESIGN ISSUES 30 Cash Flow 30 Adjustment for Risk 30 Qualified Coverage 34 8ATAX-CREDIT PLAN 38 9OBJECTIONS AND PROBLEMS 40 10 CONCLUSION 43 REFERENCES 48 ABOUT THE AUTHORS 51 vii For

Aei Evaluative Studies

he case of brief quotations embodied in news articles, critical articles, or reviews. The views expressed in the publications of the American Enterprise Institute are those of the authors and do not necessarily reflect the views of the staff, advisory panels, officers, or trustees of AEI. Printed in the United States of America To those who wait, to those who have died unnecessarily, and to the families of both. vii Contents FOREWORD, Robert B. Ekelund, Jr.xi ACKNOWLEDGMENTS xv 1INTRODUCTION 1 2THE ORGAN SHORTAGE: A BRIEF HISTORY OF A POLICY FAILURE 7 The Process of Cadaveric Organ Procurement 9 Legal and Institutional Setting 11 The Organ Shortage: Fundamentals of Supply and Demand 15 Causes of the Shortage 28 Consequences of the Shortage 31 3ALTERNATIVE POLICY PROPOSALS: A SURVEY AND COMPARATIVE ECONOMIC ANALYSIS 41 Organ Procurement Policy Alternatives 42 Social Welfare Analysis 55 Who Wins and Who Loses? 59 Appendix 3A: An Estimate of the Social Welfare Cos