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In Defense of the Middleman: Quality Failures in the Generic Pharmaceutical Market
In Defense of the Middleman: Quality Failures in the Generic Pharmaceutical Market
상세정보
- 자료유형
- 학위논문 서양
- 최종처리일시
- 20260202103131
- ISBN
- 9798280760134
- DDC
- 614
- 서명/저자
- In Defense of the Middleman: Quality Failures in the Generic Pharmaceutical Market
- 발행사항
- [Sl] : University of Pennsylvania, 2025
- 발행사항
- Ann Arbor : ProQuest Dissertations & Theses, 2025
- 형태사항
- 117 p
- 주기사항
- Source: Dissertations Abstracts International, Volume: 86-12, Section: B.
- 주기사항
- Advisor: Olssen, Alex.
- 학위논문주기
- Thesis (Ph.D.)--University of Pennsylvania, 2025.
- 초록/해제
- 요약This dissertation studies how intermediary buyers, such as wholesalers and retailers, discipline quality in the market for generic prescription drugs. Consumers are uniquely uninformed about quality in this market, since generic drugs are conventionally assumed to be interchangeable. As in many settings where consumers lack product information, they implicitly rely on intermediaries to observe quality disclosures and select high-quality goods for them. While intermediaries can alleviate adverse selection problems, they may also face incentives to choose inefficiently low-quality goods. Using novel data-the universe of FDA manufacturing quality disclosures from 2000-2022-I first provide evidence that quality failures are pervasive, even in the U.S. market. Over half of manufacturers fail inspections during my study period, and 12% of drugs are recalled, due to their risks to patient health. Next, I show that the disclosure of these failures through recall announcements reduces intermediary purchases of recalled drugs by 60%, with effects persisting for up to a decade- long after recalls are typically resolved. In contrast, the disclosure of inspection failures has little impact on drug purchases, suggesting that intermediaries penalize manufacturers more stringently for signals of supply disruptions than for low quality alone. To isolate the role of intermediaries, I develop a scoring auction model of generic procurement and an estimation technique that takes into account the fact that only winning prices are observed. I find that intermediaries are willing to pay a 2% premium for each 10% reduction in the probability of future recalls, which encourages manufacturers to compete on reliability, rather than just price. Intermediaries enhance the benefits of recall disclosures and ultimately increase the share of high-quality (not recalled) drugs by 27%. Finally, I show that counterfactual pay-for-performance policies, which subsidize high-quality drugs, can improve static welfare but are likely to reduce manufacturer competition in the long-run.
- 일반주제명
- Public health
- 일반주제명
- Pharmaceutical sciences
- 키워드
- Auctions
- 키워드
- Pharmaceuticals
- 키워드
- Pharmacies
- 키워드
- Quality failures
- 키워드
- Shortages
- 기타저자
- University of Pennsylvania Health Care Management & Economics
- 기본자료저록
- Dissertations Abstracts International. 86-12B.
- 전자적 위치 및 접속
- 로그인 후 원문을 볼 수 있습니다.
MARC
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■007cr#unu||||||||
■020 ▼a9798280760134
■035 ▼a(MiAaPQ)AAI31939633
■040 ▼aMiAaPQ▼cMiAaPQ
■0820 ▼a614
■1001 ▼aIshitani, Catherine.
■24510▼aIn Defense of the Middleman: Quality Failures in the Generic Pharmaceutical Market
■260 ▼a[Sl]▼bUniversity of Pennsylvania▼c2025
■260 1▼aAnn Arbor▼bProQuest Dissertations & Theses▼c2025
■300 ▼a117 p
■500 ▼aSource: Dissertations Abstracts International, Volume: 86-12, Section: B.
■500 ▼aAdvisor: Olssen, Alex.
■5021 ▼aThesis (Ph.D.)--University of Pennsylvania, 2025.
■520 ▼aThis dissertation studies how intermediary buyers, such as wholesalers and retailers, discipline quality in the market for generic prescription drugs. Consumers are uniquely uninformed about quality in this market, since generic drugs are conventionally assumed to be interchangeable. As in many settings where consumers lack product information, they implicitly rely on intermediaries to observe quality disclosures and select high-quality goods for them. While intermediaries can alleviate adverse selection problems, they may also face incentives to choose inefficiently low-quality goods. Using novel data-the universe of FDA manufacturing quality disclosures from 2000-2022-I first provide evidence that quality failures are pervasive, even in the U.S. market. Over half of manufacturers fail inspections during my study period, and 12% of drugs are recalled, due to their risks to patient health. Next, I show that the disclosure of these failures through recall announcements reduces intermediary purchases of recalled drugs by 60%, with effects persisting for up to a decade- long after recalls are typically resolved. In contrast, the disclosure of inspection failures has little impact on drug purchases, suggesting that intermediaries penalize manufacturers more stringently for signals of supply disruptions than for low quality alone. To isolate the role of intermediaries, I develop a scoring auction model of generic procurement and an estimation technique that takes into account the fact that only winning prices are observed. I find that intermediaries are willing to pay a 2% premium for each 10% reduction in the probability of future recalls, which encourages manufacturers to compete on reliability, rather than just price. Intermediaries enhance the benefits of recall disclosures and ultimately increase the share of high-quality (not recalled) drugs by 27%. Finally, I show that counterfactual pay-for-performance policies, which subsidize high-quality drugs, can improve static welfare but are likely to reduce manufacturer competition in the long-run.
■590 ▼aSchool code: 0175.
■650 4▼aPublic health
■650 4▼aPharmaceutical sciences
■653 ▼aAuctions
■653 ▼aPharmaceuticals
■653 ▼aPharmacies
■653 ▼aQuality failures
■653 ▼aShortages
■690 ▼a0501
■690 ▼a0338
■690 ▼a0572
■690 ▼a0573
■71020▼aUniversity of Pennsylvania▼bHealth Care Management & Economics.
■7730 ▼tDissertations Abstracts International▼g86-12B.
■790 ▼a0175
■791 ▼aPh.D.
■792 ▼a2025
■793 ▼aEnglish
■85640▼uhttp://www.riss.kr/pdu/ddodLink.do?id=T17357100▼nKERIS▼z이 자료의 원문은 한국교육학술정보원에서 제공합니다.
