Strategies for price reduction of HIV medicines under a monopoly situation in Brazil

ABSTRACT OBJECTIVE To analyze Government strategies for reducing prices of antiretroviral medicines for HIV in Brazil. METHODS Analysis of Ministry of Health purchases of antiretroviral medicines, from 2005 to 2013. Expenditures and costs of the treatment per year were analyzed and compared to international prices of atazanavir. Price reductions were estimated based on the terms of a voluntary license of patent rights and technology transfer in the Partnership for Productive Development Agreement for atazanavir. RESULTS Atazanavir, a patented medicine, represented a significant share of the expenditures on antiretrovirals purchased from the private sector. Prices in Brazil were higher than international references, and no evidence was found of a relationship between purchase volume and price paid by the Ministry of Health. Concerning the latest strategy to reduce prices, involving local production of the 200 mg capsule, the price reduction was greater than the estimated reduction. As for the 300 mg capsule, the amounts paid in the first two years after the Partnership for Productive Development Agreement were close to the estimated values. Prices in nominal values for both dosage forms remained virtually constant between 2011 (the signature of the Partnership for Productive Development Agreement), 2012 and 2013 (after the establishment of the Partnership). CONCLUSIONS Price reduction of medicines is complex in limited-competition environments. The use of a Partnership for Productive Development Agreement as a strategy to increase the capacity of local production and to reduce prices raises issues regarding its effectiveness in reducing prices and to overcome patent barriers. Investments in research and development that can stimulate technological accumulation should be considered by the Government to strengthen its bargaining power to negotiate medicines prices under a monopoly situation.

Technical progress and product reliability under competition and monopoly

Technical progress lowers costs and prices but appears to have an ambiguous effect on product reliabilty. This paper presents a simple model which explains this observation.

The evolution ofRussian power industry from monopoly to market operation

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Agency problems with non-smooth decision profiles: the case of monopoly under product quality

A method for dealing with monotonicity constraints in optimal control problems is used to generalize some results in the context of monopoly theory, also extending the generalization to a large family of principal-agent programs. Our main conclusion is that many results on diverse economic topics, achieved under assumptions of continuity and piecewise differentiability in connection with the endogenous variables of the problem, still remain valid after replacing such assumptions by two minimal requirements.

On the evolution of monopoly pricing in Internet-assisted search markets

This study examines the evolution of prices in markets with Internet price-comparison search engines. The empirical study analyzes laboratory data of prices available to informed consumers, for two industry sizes and two conditions on the sample (complete and incomplete). Distributions are typically bimodal. One of the two modes of distribution, corresponding to monopoly pricing, tends to attract such pricing strategies increasingly over time. The second one, corresponding to interior pricing, follows a decreasing trend. Monopoly pricing can serve as a means of insurance against more competitive (but riskier) behavior. In fact, experimental subjects who initially earn low profits due to interior pricing are more likely to switch to monopoly pricing than subjects who experience good returns from the start.

Barriers to entry in monopoly markets: automobile distribution in Brazil

O Objetivo deste Trabalho é Analisar os Efeitos da Entrada de uma Segunda Concessionária de Automóveis em Mercados Previamente Monopolizados. para Tanto, Construiu-Se um Banco de Dados com a Localização de Concessionárias de Automóveis em Microrregiões e Características Demográficas e Econômicas Destas Microrregiões. a Partir Desse Banco de Dados e de Modelos de Escolha Binária, Foram Identificadas Variáveis que Condicionam a Existência e o Número de Concessionárias em Microrregiões. Utilizando-Se de um Modelo Adaptado de Bresnahan e Reiss (1990), Foram Estimados os Custos Fixos de Entrada de Concessionárias em Mercados Monopolizados. os Resultados Obtidos Sugerem que as Barreiras À Entrada não são Significativas, o que Aumenta a Probabilidade de que a Cláusula de Exclusividade nos Contratos de Concessão não Cause Danos À Concorrência no Mercado Brasileiro de Distribuição de Automóveis

Monopoly power, trade protection and growth: cross industry evidence

This paper investigates the impact of monopoly power on trade policy. Annual panel-databases of Brazilian industries for the years 1988 through 1994 were used. The regressions reported here are robust to openness indicator, concentration index, control variables and sample size, and suggest that industries with higher monopoly power are more protected than competitive sectors. In the period of study the country experienced a major trade liberalization, but the results in the paper show that the reduction in protection was smaller in sectors with higher monopoly power. We thus have evidence favoring recent growth literature which stresses that interest groups with control over creasing productivity. The results here confirm the first part of this argument and show that organized groups in fact are able to obtain policy advantages that reduce competition.

Relationship banking: does it lower information asymmetry or increase lender monopoly power?

A literatura teórica sobre economia bancária aponta que o relacionamento duradouro entre um emprestador e uma firma tomadora pode revelar informações sobre a qualidade de crédito da firma. Entretanto, trabalhos teóricos preveem diferentes resultados do efeito do relacionamento bancário sobre a taxa de juros e volume ofertado do empréstimo. De acordo com Diamond (1991) e outros, se o relacionamento bancário for revelar a todos os credores a qualidade de crédito da firma, espera-se como efeitos o aumento do volume dos empréstimos e redução na taxa de juros. Por outro lado, se o relacionamento bancário revelar as informações de crédito da firma apenas para o fornecedor principal, então se pode não ter os efeitos de aumento do volume e redução na taxa de juros. Este trabalho demonstra empiricamente quais são os efeitos das informações públicas e privadas geradas pelo relacionamento bancário no montante do empréstimo e na taxa de juros cobrada pelas instituições financeiras para as firmas. Usamos como medida de informação pública o tempo de relacionamento entre o banco e tomador, que pode ser encontrado em bureaux externos como Serasa Experian e Serviço Central de Proteção ao Crédito (SCPC) ou no Sistema de Informação do Banco Central (SISBACEN). Usamos como modelo de informação privada medidas que indicam o pagamento do débito em atraso por parte do tomador, o qual é de conhecimento apenas de cada credor. De acordo com a teoria, espera-se que a informação pública de tempo de relacionamento bancário indicará a qualidade do credor e resultará em maior volume de empréstimo e taxa de juros menores. As informações privadas sobre pagamentos em atraso, por ser exclusiva do credor principal, não terão efeitos sobre o montante do empréstimo e sobre a taxa de juros. No teste empírico, foram analisados dois mil setecentos e oitenta e cinco empréstimos do produto capital de giro concedidos a cinquenta e três empresas, fornecidos por uma instituição financeira do Estado do Espírito Santo. Utilizando o modelo econométrico dados em painel com efeito fixo de firma, encontramos que o tempo de relacionamento bancário é positivamente correlacionado ao valor do principal do empréstimo e é negativamente correlacionado ao spread bancário. Ambos os efeitos são estatisticamente significantes ao nível de 5,00%. Resultados similares ao encontrado por Berger e Udell (1995). Os resultados mostram que um relacionamento duradouro entre firmas e instituições financeiras reduz a assimetria de informação, gerando benefícios para as firmas. Para testar o feito da informação privada, foram utilizadas informações de atraso das firmas com a instituição financeira. Esses dados foram usados internamente, não divulgados em bureaux de crédito. As variáveis testadas foram número de parcelas pagas em atraso no mês anterior, a soma das parcelas pagas em atraso, flag se já efetuou pagamento em atraso e meses desde o último pagamento em atraso. Não têm efeito as informações privadas sobre o spread e o valor do principal do empréstimo. Resultados similares aos encontrados por Sharpe (1990).

Monopoly power and trade protection: cross- industry evidence

This paper investigates the impact of industry concentration on trade policy. Annual panel-databases of Brazilian industries for the years 1988 through 1994 were used. The regressions reported here are robust to openness indicator. concentration index, control variables and sample size, and suggest that the higher the concentration of a given industry the higher its leveI of trade protection. In the period of study the country experienced a major trade liberalization, but the results in the paper show that the reduction in protection was smaller in more concentrated sectors. Assuming that concentration is ;1 gCl()d proX\' for mOllopoh' po\\'er as it reduces the free-rider problem in coordinating a lobby the results in this paper indicates that interest groups with control over specific markets in fact are able to obtain policy advantages that reduce (international) competition.

Monopoly rights can reduce income big time

We study a two–sector version of the neoclassical growth model with coalitions of factor suppliers in the capital producing sectors. We show that if the coalitions have monopoly rights, then they block the adoption of the efficient technology. We also show that blocking leads to a decrease in the productivity of each capital producing sector and to an increase in the relative price of capital; as a result the capital stock and the production fall in each sector. We finally show that the implied fall in the level of per–capita income can be large quantitatively.