What if there was a stronger pharmaceutical price competition in Spain? When regulation has a similar effect to collusion

This paper examines statins competition in the Spanish pharmaceutical market, where prices are highly regulated, and simulates a situation in which there is unrestricted price competition. A nested logit demand model is estimated with a panel of monthly data for pharmaceuticals prescribed from 1997 to 2005. The simulation indicates that the regulation of prices is similar in its effects to cooperation among producers, since the regulated prices are close to those that would be observed in a scenario of perfect collusion. Freedom to set prices and a regulatory framework with appropriate incentives would result in a general reduction in prices and may make the current veiled competition in the form of discounts to pharmacists become more visible. The decrease in prices would be partially offset by an increase in consumption but the net effect would be an overall decrease in expenditure. The counterfactual set-up would also lead to important changes in the market shares of both manufacturers and active ingredients, and a reversal of generic drugs. Therefore, pro-competitive regulation would be welfare-enhancing but would imply winners and losers.

Generic drugs in Spain: price competition vs. moral hazard

This paper examines competition between generic and brand-name drugs in the regulated Spanish pharmaceutical market. A nested logit demand model is specified for the three most consumed therapeutic subgroups in Spain: statins (anticholesterol), selective serotonin reuptake inhibitors (antidepressants) and proton pump inhibitors (antiulcers). The model is estimated with instrumental variables from a panel of monthly prescription data from 1999 to 2005. The dataset distinguishes between three different levels of patients’ copayments within the prescriptions and the results show that the greater the level of insurance that the patient has (and therefore the lower the patient’s copayment), the lower the proportion of generic prescriptions made by physicians. It seems that the low level of copayment has delayed the penetration of generics into the Spanish market. Additionally, the estimation of the demand model suggests that the substitution rules and promotional efforts associated with the reference pricing system have increased generic market share, and that being among the first generic entrants has an additional positive effect.

Age effects, unobserved characteristics and hedonic price indexes: The Spanish car market in the 1990s

This paper computes and compares alternative quality-adjusted price indexes for new cars in Spain in the period 1990-2000. The proposed hedonic approach simultaneously controls for time-invariant unobserved product e¤ects and time-variant unobserved quality changes, that are assumed to be captured by model age effects. The results show that the non-adjusted price index largely overstates the increase in the cost of living induced by changes in car prices and that previous evidence for this market have not measured the real extent of that bias, probably due to the omission of controls for unobservables. It is also shown that omitting age effects can also lead to misleading conclusions. The estimated price indexes give also some insights on what could have been the determinants of price evolution in the Spanish car market.

Age effects, unobserved characteristics and hedonic price indexes: The Spanish car market in the 1990's

This paper computes and compares alternative quality-adjusted price indexes for new cars in Spain in the period 1990-2000. The proposed hedonic approach simultaneously controls for time-invariant unobserved product effects and time-variant unobserved quality changes, that are assumed to be captured by model age effects. The results show that the non-adjusted price index largely overstates the increase in the cost of living induced by changes in car prices and that previous evidence for this market have not measured the real extent of that bias, probably due to the omission of controls for unobservables. It is also shown that omitting age effects can also lead to misleading conclusions. The estimated price indexes give also some insights on what could have been the determinants of price evolution in the Spanish car market. JEL classi…fication numbers: C43, E31, L11, L13, Keywords: Hedonic price indexes, Spanish car market, car prices, CPI, Cost of living

Uranium reserve, nuclear fuel cycle delusion, CO2 emission from the sea, and electricity supply: reflections after the fuel meltdown of Fukushima nuclear power units

The Great Tohoku-Kanto earthquake and resulting tsunami has brought considerable attention to the issue of the construction of new power plants. We argue in this paper, nuclear power is not a sustainable solution to energy problems. First, we explore the stock of uranium-235 and the different schemes developed by the nuclear power industry to exploit this resource. Second, we show that these methods, fast breeder and MOX fuel reactors, are not feasible. Third, we show that the argument that nuclear energy can be used to reduce CO2 emissions is false: the emissions from the increased water evaporation from nuclear power generation must be accounted for. In the case of Japan, water from nuclear power plants is drained into the surrounding sea, raising the water temperature which has an adverse affect on the immediate ecosystem, as well as increasing CO2 emissions from increased water evaporation from the sea. Next, a short exercise is used to show that nuclear power is not even needed to meet consumer demand in Japan. Such an exercise should be performed for any country considering the construction of additional nuclear power plants. Lastly, the paper is concluded with a discussion of the implications of our findings.

Community Education Needs to be Supported by Strong Public Policy to Tackle Food Poverty

Community education needs to be supported by strong public policy if it is to be fully effective at tackling food poverty and obesity, a project evaluation by the Institute of Public Health in Ireland (IPH) has found. In its evaluation of Decent Food for All (DFfA) - a major project to improve community diet and health - IPH found that where people live and shop had a greater impact on their diet than their own individual awareness and attitudes. Access Tackling Food Poverty: lessons from the Decent Food for All intervention at www.publichealth.ie DFfA was funded by safefood (the Food Safety Promotion Board) and the Food Standards Agency Northern Ireland. The project lasted four years and included hundreds of community education activities designed to improve diet in poorer parts of Armagh and South Tyrone. safefood commissioned IPH to undertake the evaluation of DFfA. Dr. Kevin Balanda, IPH Associate Director, said 'The aim of the project was to reduce food poverty (this is defined as not being able to consume adequate healthy food) and improve health in the target communities. DFfA delivered over 370 core activities to 3,100 residents including local education talks on diet, cookery workshops, fresh fruit in schools, healthy food tastings and information stands. One in eight residents in the target areas participated in at least one of these activities.' The evaluation found that over 1 in 5 adults in the target areas reported they had cut their weekly food spending in the last six months to pay other household bills such as rent, electricity and gas. During the four years of the DFfA activities, this percentage had not changed significantly. There were mixed changes in the nature of food in local stores. While the overall availability and price of food increased, both ﾓhealthierﾔ food and ﾓunhealthierﾔ food were included in that increase. It was only in the larger ﾓmultiple/discount freezerﾔ type of shops that the overall price of food had decreased.

Price policies and Price dispersion in the private healthcare insurance industry: The Catalan case

We present an overlapping generations model that explains price dispersion among Catalonian healthcare insurance firms. The model shows that firms with different premium policies can coexist. Furthermore, if interest rates are low, firms that apply equal premium to all insureds can charge higher average prices than insurers that set premiums according to the risk of insured. Economic theory, health insurance, health economics.

Factor shares, the price markup, and the elasticity of substitution between capital and labor.

In a Walrasian labor market, the labor income share is constant under the assumptions of a Cobb-Douglas production function and perfect competition. Given the observed decline of the labor share in recent decades, this paper relaxes these assumptions, proposes a time-series calculation of the aggregate price mark-up reflecting the degree of imperfect competition in the product market, and provides estimates of the elasticity of substitution under such product market imperfections. We focus on Spain and the U.S. and show that the elasticity of substitution is above one in Spain and below one in the U.S. We also show that the price markup drives the elasticity of substitution away from one, upwards in Spain, downwards in the U.S. These results are used to explain the declining path of the labor income share, common to both economies, and their contrasted patterns in terms of capital deepening.

Report to the Minister for Health and Children: Independent Examination related to the Medical Council and South-Eastern Health Board (Dr John Harding Price)

The Minister for Health and Children has requested that an independent review be carried out of the circumstances surrounding the employment of a UK based Consultant Psychiatrist, Dr John Harding-Price, to a locum psychiatrist position with the South Eastern Health Board (SEHB) while he was suspended by the General Medical Council (GMC) in the United Kingdom and consequently the subject of legal proceedings by the Medical Council in Ireland. The Consultant was continuously registered with the Medical Council since 1968. Download the document here

The London health inequalities forecast: Technical document

This paper describes the data and methods used in the London health inequalities forecast: A briefing on inequalities in life expectancy and deaths from cancers, heart disease and stroke in London. Links to relevant data sources and further information are also provided where possible.

The London health inequalities forecast: A briefing on inequalities in life expectancy and deaths from cancers, heart disease and stroke in London

This briefing considers the national health inequalities targets which must be met by 2010. The targets include those set for heart disease and stroke, cancers and life expectancy.

What Price Salvation? The Exchange of Salvation goods between India and the West

Does Weber's notion of salvation goods, along with the connected one of the religious market, apply to the modern history of yoga? The case study chosen here (the yoga of Pattabhi Jois) clearly shows that these notions highlight many aspects of the expansion of yoga into a global market product. However, the notion of salvation goods resists the new hermeneutical situation of encounter and has to be adapted to the present situation of religious "patchwork". The notion of religious market lacks depth to describe the various understandings and appropriations of yoga in precise historical situations. Other aspects of the current global status of yoga may be highlighted by applying the concept of pilgrimage. La notion de bien de salut que nous lègue Max Weber et la notion de marché religieux qui en découle peuvent-elles s'appliquer à l'histoire moderne du yoga? L'étude de cas que nous consacrons au yoga de Pattabhi Jois montre que ces notions éclairent bien certains aspects de l'expansion du yoga en tant que produit d'un marché globalisé. Cependant la notion de bien de salut résiste à une réflexion de type herméneutique sur les processus de rencontres et doit être adaptée à la situation contemporaine, ou` les religions se présentent comme des ensembles composites. La notion de marché religieux ne permet pas d'expliquer les diverses compréhensions et appropriations du yoga dans des situations historiques précises. D'autres aspects de la situation du yoga sont mieux explicités si on prend le concept de pèlerinage comme point de référence.

How to Measure Scope Variables when no Metrics Exist : Application to Landscape Quality Measurement and Hedonic Price Evaluation

Landscape is an example of a non-market good where no metrics exist to measure its quality. The paper proposes an original methodology to nevertheless estimate scope variables in those circumstances, allowing then to better test if people's willingnesstopay for such good is sensitive to the scope. The methodology is based on techniques developed in the context of multicriteria decision analysis. It is applied to assess the quality of the landscape of several Swiss alpine resorts. This assessment is then used as an explanatory variable in a hedonic price function to explain the rent of apartments and to derive an implicit price of the landscape quality.