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Full-Text Articles in Insurance

Behavioral Economics And Insurance: Principles And Solutions, Howard Kunreuther, Mark V. Pauly Phd Aug 2015

Behavioral Economics And Insurance: Principles And Solutions, Howard Kunreuther, Mark V. Pauly Phd

Health Care Management Papers

It is easy for a consumer to make mistakes in insurance markets, especially when deciding whether to purchase insurance against low-probability, high-consequence (LP-HC) events. They have a hard time collecting and processing information to determine the likelihood and consequences of these risks which (by definition) they have had limited or no experience. Hence, people often rely on feelings and intuition rather than careful thought when it comes time to decide what coverage to purchase.


Pharmacy Benefit Management: Are Reporting Requirements Pro- Or Anticompetitive?, Patricia M. Danzon Jun 2015

Pharmacy Benefit Management: Are Reporting Requirements Pro- Or Anticompetitive?, Patricia M. Danzon

Health Care Management Papers

The market-based US health care system relies on pharmacy benefit managers (PBMs) to control pharmaceutical costs, in contrast to most other countries that regulate drug prices and access. Optimal strucuturing and regulation of PBM contracts poses significant agency challenges for private and public payers. However, recent reporting requirements for PBMs may be counterproductive and reflect the interests of competitors rather than customers.


Value-Based Differential Pricing: Efficient Prices For Drugs In A Global Context, Patricia. M. Danzon, Adrian Towse, Jorge Mestre-Ferrandiz Mar 2015

Value-Based Differential Pricing: Efficient Prices For Drugs In A Global Context, Patricia. M. Danzon, Adrian Towse, Jorge Mestre-Ferrandiz

Health Care Management Papers

This paper analyzes pharmaceutical pricing between and within countries to achieve second-best static and dynamic efficiency. We distinguish countries with and without universal insurance, because insurance undermines patients' price sensitivity, potentially leading to prices above second-best efficient levels. In countries with universal insurance, if each payer unilaterally sets an incremental cost-effectiveness ratio (ICER) threshold based on its citizens' willingness-to-pay for health; manufacturers price to that ICER threshold; and payers limit reimbursement to patients for whom a drug is cost-effective at that price and ICER, then the resulting price levels and use within each country and price differentials across countries are ...