61. Pharmaceutical Pricing and Access Policies: A Study of the Impact of Physicians' Imperfect Adherence to Prescribing Guidelines.
Contributed abstract in session MD-4: Cost Effectiveness, stream Regular talks.
Monday, 13:50-15:00Room: Room S3
Authors (first author is the speaker)
| 1. | Rezvan Shahabbasi
|
| Ivey Business School, University of Western Ontario | |
| 2. | Greg Zaric
|
| Ivey School of Business, Western University | |
| 3. | Prashant Chintapalli
|
| Management Science, Ivey Business School, Western University |
Abstract
The rising costs of prescription drugs pose a significant challenge to healthcare systems. To address rising costs and uncertainties associated with new drugs, many payers have implemented various risk-sharing or managed entry agreements. In this study, we introduce an analytical framework that considers the impact of physicians' imperfect adherence to prescribing guidelines when setting drug prices and coverage thresholds in risk-sharing agreements. In our model, physicians are categorized into three groups based on their level of adherence to prescribing guidelines. The goal for the public payer is to maximize net monetary benefit (NMB), while the manufacturer aims to optimize its profit. We use a Stackelberg game framework to model the decision-making process where the manufacturer moves first and sets the price, and then the payer determines the access conditions. Our results demonstrate that optimal policies vary based on the degree of imperfect adherence to prescribing guidelines and the proportion of physicians who prescribe imperfectly. This study underscores the importance of accounting for imperfect adherence to prescribing guidelines in healthcare decision-making, benefiting payers, patients, and manufacturers in the industry. In contrast to prior research, our findings reveal that physician’s deviation from guidelines introduces variability in optimal decisions related to price and threshold which is influenced by the type and proportion of physicians involved.
Keywords
- Cost effectiveness and health economics
- Healthcare policy modelling
Status: accepted
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