state characteristics and the location of foreign direct investment within the united states a conditional logit model of the location decision of foreign firms investing in manufacturing facilities in the united states is developed and estimated the authors results for 1981 83 indicate that states with higher per capita incomes and higher densities of manufacturing activity attracted relatively more foreign direct investment in addition higher wages deterred foreign direct investment while higher unemployment rates attracted it surprisingly higher unionization rates were associated with increased foreign direct investment overall higher taxes deterred foreign direct investment however more extensive transportation infrastructures and larger promotional expenditures were associated with increased foreign direct investment copyright 1991 by mit press

does health plan generosity enhance hospital market power we test whether the generosity of employer sponsored health insurance facilitates the exercise of market power by hospitals we construct indices of health plan generosity and the price and volume of hospital services using data from truven marketscan for 601 counties from 2001 to 2007 we use variation in the industry and union status of covered workers within a county over time to identify the causal effects of generosity although ols estimates fail to reject the hypothesis that generosity facilitates the exercise of hospital market power iv estimates show a statistically significant and economically important positive effect of plan generosity on hospital prices in uncompetitive markets but not in competitive markets our results suggest that most of the aggregate effect of hospital market structure on prices found in previous work may be coming from areas with generous plans

the strategic interaction between firms and formulary committees effects on the prices of new drugs we study the strategic interaction between the pricing decisions of a pharmaceutical firm and the reimbursement decisions of a government agency which grants reimbursement rights to patients for whom new drugs are most cost effective if the reimbursement decision precedes pricing the agency only reimburses some patients if the drug s private and public health benefits diverge this is there are consumption externalities and the variable cost of the drug exceeds the alternative s contrarily if the firm can commit to a price before reimbursement a strategic effect implies that by setting a sufficiently high price the firm can make the agency more willing to reimburse than without commitment

the medicaid notch labor supply and welfare participation evidence from eligibility expansions i assess the impact of losing public health insurance on labor market decisions of women by examining a series of medicaid eligibility expansions targeted toward young children these targeted expansions severed the historical tie between afdc and medicaid eligibility the reforms allowed a mother s earnings to increase without losing public health insurance for her young children increasing the income limit for medicaid resulted in a decrease in afdc participation and an increase in labor force participation among these women the effects were large for ever married women and negligible for never married women

does public insurance crowd out private insurance the cost of expanding public sector health programs depends critically on the extent to which public eligibility will cover just the uninsured or will crowd out existing private insurance coverage we estimate the extent of crowd out arising from the expansions of medicaid to pregnant women and children over the 1987 1992 period we estimate that approximately 50 percent of the increase in medicaid coverage was associated with a reduction in private insurance coverage this occurred largely because employees took up employer based insurance less frequently there is also some evidence that employers contributed less for insurance and that workers dropped coverage of dependents

international trade and investments in a vertically differentiated industry abstract a model of vertical product differentiation is applied to the study of trade and investments between two economies of differing sizes at the autarky equilibrium firms in the smaller country are shown to produce lower quality the choice of the firms between exports and foreign investments when borders open is studied intra industry trade or reciprocal investments arise when the quality gap is not too wide the strategic role of foreign investments is emphasized in particular the establishment of a subsidiary abroad can crowd out both sales by local firms and exports by the co national firm

an exploration in the theory of exchange rate regimes three exchange rate regimes a float a one sided peg and a cooperative peg are evaluated and compared in terms of efficiency and welfare levels the framework of analysis embodies country specific monies with the money of each country being used to transact in its commodity markets and its currency denominated bonds welfare levels depend only on consumption levels in the presence of perfect foresight all equilibrium allocations are pareto efficient in a floating exchange rate regime the perfect foresight equilibrium allocation coincides with an equilibrium of a costless barter economy the same result holds in a one sided peg if the pegging country s exchange rate stabilizing authority breaks even over time in a cooperative peg regime there is a different equilibrium allocation for each combination of exchange rate levels and monetary policies problems of policy coordination and conflicts in desired monetary policies are discussed

news shocks in the data olympic games and their macroeconomic effects we examine the macroeconomic effects of bidding for the olympic games using panel data for 188 countries during the period 1950 2009 our findings confirm that economies react to news shocks investment consumption and output significantly increase 9 to 7 years before the actual event in bidding countries hosting countries also experience significant increases in investment consumption and output 5 to 2 years before the hosting of the games mapping the olympics into a macroeconomic model we show that we can match our empirical findings if we assume that an olympic bid represents news about increases in government investment

money and growth an alternative approach this paper takes an alternative approach to the topic of money and growth by developing a model in which the effects of sustained capital accumulation on an evolving system of payments in addition to the conventional effects of sustained inflation on growth are examined while the effects of inflation on growth are small the effects of growth on the monetary system are substantial the results are consistent with ideas about money and growth contained in work that predates that of james tobin and miguel sidrauski as well as with evidence that money and asset demands vary systematically within economies as they develop copyright 1994 by american economic association

imitation contagion or exertion using a tax reform to reveal how colleagues sick leaves influence worker behaviour we analyse the social interaction effects in sick leave behaviour in the workplace using high quality norwegian matched employer employee data with detailed individual information on sick leaves during the 2004 2006 period we find that social interaction effects in sick leave behaviour in the workplace do exist and that the effects are noticeable in size the strong relationship between the sick leave rates among colleagues is not solely the result of contagious diseases nor is it caused by improved informational quality or by the increased workload for the non absent workers evidence supports the existence of reciprocal worker behaviour that is unrelated to joint leisure seeking activities

entry barriers exit and sunk costs an analysis the relationship between entry rates entry barriers and sunk costs are examined across a set of four digit industry data results indicate that product differentiation barriers reduce entry rates and sunk capital costs reduce exit rates whether entry and exit are truly simultaneous however is not clear

endogenous cost effectiveness analysis and health care technology adoption abstract increased health care spending has placed pressure on public and private payers to prioritize spending cost effectiveness ce analysis is the main tool used by payers to prioritize coverage of new therapies we argue that reimbursement based on ce is subject to a form of the lucas critique the goals of ce policies may not materialize when firms affected by the policies respond optimally to them for instance because costs in ce analysis reflect prices set optimally by firms rather than production costs observed ce levels will depend on how firm pricing responds to ce policies observed ce is therefore endogenous when ce is endogenously determined policies aimed at lowering spending and improving overall ce may paradoxically raise spending and lead to the adoption of more resource costly treatments we empirically illustrate whether this may occur using data on public coverage decisions in the united kingdom

regulation of price increases abstract u s federal and state governments rarely regulate healthcare price levels but do regulate price changes for pharmaceuticals hospitals and health insurance previous research showed that limiting price increases can raise launch prices and reduce both profit and social welfare assuming consumers are myopic we show that with forward looking consumers limiting price increases can have the opposite effect that is launch prices fall while profit and social welfare rise ironically inflation regulation can cause inflation to rise but only because firms are reducing launch prices to make the regulation bind and credibly commit to future prices

static and dynamic effects of health policy evidence from the vaccine industry public policies designed to increase utilization of existing technologies may also affect incentives to develop new technologies this paper investigates this phenomenon by examining policies designed to increase usage of preexisting vaccines i find that these policies were associated with a 2 5 fold increase in clinical trials for new vaccines for several diseases the induced innovation is socially wasteful though small in magnitude in one case however the dynamic social welfare benefits from induced innovation exceed the policies static benefits from increasing vaccination with existing technology these findings underscore the importance of including technological progress in economic analysis of public policy

pharmaceutical r d spending and threats of price regulation do threats of pharmaceutical price regulation affect subsequent research and development r d spending this study uses the clinton administration s health security act hsa of 1993 as a natural experiment to study this issue we link events surrounding the hsa to pharmaceutical stock price changes and then examine the cross sectional relation between firms stock price changes and their subsequent unexpected r d spending changes re sults show that the hsa had significant negative effects on stock prices and firm level r d spending conservatively the hsa reduced r d spending by about 1 billion even though it never became law

the eclectic paradigm of international production a restatement and some possible extensions this article reviews some of the criticisms directed towards the eclectic paradigm of international production over the past decade and restates its main tenets the second part of the article considers a number of possible extensions of the paradigm and concludes by asserting that it remains a robust general framework for explaining and analysing not only the economic rationale of economic production but many organisational and impact issues in relation to mne activity as well

source country characteristics and the inflow of foreign direct investment into saudi arabia the paper examines the impact of source country characteristics on the inflow of fdi into saudi arabia using a gravity type model including economic distance and socio political variables a unique database listing all new investments involving foreign ownership is used to construct a panel of 33 countries in the period 1980 2005 to account for many country year observations with zero fdi the negative binomial regression the tobit regression and the heckman selection procedure are used the conclusions drawn from the analysis employing panel based techniques differ from the results obtained from pooled regression models also the determinants of fdi differ depending on whether foreign investment is measured in terms of investment expenditure or the number of individual foreign projects the heckman selection results reveal that there are a large number of factors affecting the decision to invest in saudi arabia compared with relatively few determinants of the actual size of investment traditional size and distance characteristics hold to a great extent but the relationship between fdi and bilateral trade is unclear and there is some evidence that the countries that export to saudi arabia do not invest there in terms of scope for possible spillovers there is mixed evidence on whether the investment comes from more technologically advanced economies but volume wise important investments originate from countries characterised by high income per capita

r d in the pharmaceutical industry a world of small innovations it is commonly argued that in recent years pharmaceutical companies have targeted their research and development r d at small improvements of existing compounds instead of riskier drastic innovations in this paper we show that the bias in the pharmaceutical industry toward small innovations might be driven by the low sensitivity of the demand in particular small innovations get a proportionally larger reward because pharmaceutical firms target them at the inelastic segments of the demand as a consequence firms find it relatively more profitable to invest in small innovations we also study the effect on r d incentives of marketing strategies and regulatory instruments aimed at controlling pharmaceutical expenditure

price discrimination and bargaining empirical evidence from medical devices many important issues in business to business markets involve price discrimination and negotiated prices situations where theoretical predictions are ambiguous this paper uses new panel data on buyer supplier transfers and a structural model to empirically analyze bargaining and price discrimination in a medical device market while many phenomena that restrict price discrimination are suggested as ways to decrease hospital costs e g mergers group purchasing organizations and transparency i find that 1 non discriminatory pricing actually works against hospitals because competition is more intense under price discrimination and 2 results depend ultimately on a previously unexplored bargaining effect

determinants of inward investment in the uk a panel analysis this paper develops an inter industry model of inward investment using a fixed effects approach this demonstrates that when inward investment is investigated in such a framework previous findings relating to the specification of measures of location advantage and ownership advantages no longer hold this also shows that there are some industries that have attracted significant inward investment over time and continue to do so while others are noticeably less successful reasons for this and potential policy measures are briefly discussed

perverse reverse price competition average wholesale prices and medicaid pharmaceutical spending abstract generic drugs comprise an increasing share of total prescriptions dispensed in the u s rising from nearly 50 in 1999 to 75 in 2009 the generic drug market has typically been viewed at the wholesale level as a competitive market with price approaching marginal costs however the large presence of third party payers as final purchasers may distort prices at the retail level relative to what a standard model of price competition would predict in this paper we investigate how generic drug producers compete in the presence of the procurement rules of the medicaid program medicaid reimbursement to pharmacies like that of other payers is based on a benchmark price called the average wholesale price awp the awp is reported by generic producers themselves and until recently has been subject to essentially no independent verification as a result generic producers have had an incentive to compete for pharmacy market share by reporting awps that exceed actual average wholesale prices as this spread leads to larger pharmacy profits in 2000 after a federal government audit of actual wholesale prices of generic products states were advised to reduce medicaid reimbursement by as much as 95 for about 400 generic and off patent drug products we use variation induced by the timing of this policy along with its differential impact on drug products medicaid reimbursement to estimate the impact of this exogenous price change on the market share of targeted products our findings indicate that pharmacies did respond to the perverse incentives of the medicaid program by dispensing products with the highest awps overall the medicaid market share fell by about 45 for targeted drug products as a result of the policy

behavior of the firm under regulatory constraint a recent article by akira takayama discusses an earlier paper by harvey averch and leland l johnson on fair rate of return regulation of public utilities although takayama p 255 agrees with averch and johnson s general conclusions that a firm will tend to increase its investment with the introduction of an active constraint on its rate of return he criticizes the a j argument as being confusing ambiguous and in error takayama then attempts a clarification and presents a new formulation which leads to the a j result quoted above this comment will discuss several of takayama s criticisms in addition to showing that the so called a j effect cannot be derived from the basic assumptions made by both averch and johnson and takayama 1 we will show that the very assumptions used to prove the a j effect by defining the region of x require an assumption that the a j effect exists in the first place

innovation and the welfare effects of public drug insurance rewarding inventors with inefficient monopoly power has long been regarded as the price of encouraging innovation prescription drug insurance escapes that trade off and achieves an elusive goal lowering static deadweight loss without reducing incentives for innovation as a result of this feature the public provision of drug insurance can be welfare improving even for risk neutral and purely self interested consumers the design of insurers cost sharing schedules can either reinforce or mitigate this result schedules that impose higher consumer cost sharing requirements on more expensive drugs help ensure that insurance subsidies translate into higher utilization rather than pure increases in manufacturer profits moreover some degree of price negotiation with manufacturers is likely to be welfare improving but the optimal degree depends on the size of such transactions costs as well as the social cost of weakening innovation incentives by lowering innovator profits these results have practical implications for the evaluation of public drug insurance programs like the us medicaid and medicare part d programs along with european insurance schemes

pricing patent loss and the market for pharmaceuticals dustry the drug price competition and patent term restoration act of 1984 very clearly reflects the determination of policy makers to simultaneously address issues of price control and technical progress the 1984 act increased returns to innovation by extending the period of patent protection to take into account the time between receipt of a patent and food and drug administration fda approval of a drug for sale in the market the 1984 act also reduced the testing requirements for approval of new generic brands of existing chemical entities thus reducing entry barriers in markets where patents have expired the expected outcome from eased entry conditions for generic substitutes was substantially enhanced price competition and lower prices for brand name drugs in fact prices for brand name drugs have tended to increase following entry by generics wagner and duffy 28 examined price changes for top selling generics and name brands they show substantial price increases in brand name prices accompanying large reductions in generic prices as entry of generics occurs grabowski and vernon 9 examined data on 18 major orally administered rug products subject to generic competition between 1983 and 1987 and found that the name brand price increased by an average of 7 one year subsequent to generic entry and 11 two years following generic entry

the medium term impact of medicare part d on pharmaceutical prices medicare part d began coverage of prescription drugs in 2006 using data from the first year of the program we found that part d reduced pharmaceutical prices for medicare recipients with these effects driven by enrollees previously without drug coverage in this paper we extend our analysis through 2009 the fourth year of the program to investigate whether plans continued to extract price concessions in return for favorable formulary placement or if consumer inertia or other factors caused prices to bounce back after their initial decline we find price declines persisted through at least the third year of the program

reference pricing competition and pharmaceutical expenditures theory and evidence from a natural experiment abstract we study the impact of regulation on competition between brand names and generics and pharmaceutical expenditures using a unique policy experiment in norway where reference pricing rp replaced price cap regulation in 2003 for a sub sample of off patent products first we construct a vertical differentiation model to analyze the impact of regulation on prices and market shares of brand names and generics then we exploit a detailed panel data set at product level covering several off patent molecules before and after the policy reform off patent drugs not subject to rp serve as our control group we find that rp significantly reduces both brand name and generic prices and results in significantly lower brand name market shares finally we show that rp has a strong negative effect on average molecule prices suggesting significant cost savings and that patients copayments decrease despite the extra surcharges under rp

transactions cost economics and the multinational enterprise an assessment abstract this paper applies transactions cost principles to the multinational enterprise in order to ascertain its distinctive properties as a mode of economic organization the analysis helps identify just when and where contractual alternatives to the multinational firm are likely to be viable this turns out to depend upon the nature of the technology the regime of appropriability within which the firm operates and the characteristics of the markets in question transactions cost analysis is also extended to the multinational enterprise host country relationship implications for management and public policy are derived

investigating geography and institutions as determinants of foreign direct investment in africa using panel data this article uses a cross country econometric approach to identify the determinants for foreign direct investment fdi in africa the contribution is 3 fold firstly we recognize that the estimation techniques used elsewhere such as ordinary least squares may be flawed we therefore use a dynamic one step generalized method of moments gmm estimator due to arellano and bond 1991 the gmm estimates identified a number of robust determinants of fdi namely government consumption inflation rate investment governance political stability accountability regulatory burden rule of law and initial literacy it is concluded that geography does not seem to have a direct influence on fdi flows to africa neither market seeking nor re exporting motives of fdi seem to dominate with different policy instruments being significant in the different specifications this does not discount the importance of good policies but probably indicates the importance of good policies made by good institutions institu

health insurance subsidies and deductible choice evidence from regional variation in subsidy schemes the extent to which premium subsidies can influence health insurance choices is an open question in this paper we explore the regional variation in subsidy schemes in switzerland designed as either in kind or cash transfers to study their impact on the choice of health insurance deductibles using health survey data and a difference in differences methodology we find that in kind transfers increase the likelihood of choosing a low deductible plan by approximately 4 percentage points or 7 our results indicate that the response to in kind transfers is strongest among women middle aged and unmarried individuals which we explain by differences in risk taking behavior health status financial constraints health insurance and financial literacy we discuss our results in the light of potential extra marginal effects on the demand for health care services which are however not supported by our data

locational advantage and us foreign direct investment in uk manufacturing the relationship between foreign direct investment fdi and international trade is examined with specific reference to us fdi in the uk four complementary hypotheses are tested on a cross section of uk industries there is evidence of us fdi being located in uk industries which have a revealed comparative advantage and that large market size effects are important on the other hand little evidence was found for the protection jumping and industrial concentration hypotheses

how much does subnational region matter to foreign subsidiary performance evidence from fortune global 500 corporations investment in china what explains the heterogeneity of foreign subsidiary performance previous studies have emphasized the importance of industry corporate parent and home country effects on the variation of foreign subsidiary performance building on recent international business and economic geography research this study examines the extent to which subnational region effects can also explain such performance variation we empirically decompose the variance of the performance of fortune global 500 corporations subsidiaries in china during 1998 2006 results show that not only are subnational region effects statistically significant in explaining the variation of subsidiary performance but their interactions with industry corporate parent and home country effects are also significant and economically important we further show that subnational region effects tend to be stronger in the period prior to china s wto accession and in the country s less developed subnational regions our findings highlight the importance of considering both the direct and indirect roles of subnational region in shaping firms strategy and performance in international business research

the distortionary effects of government procurement evidence from medicaid prescription drug purchasing in 2003 the federal state medicaid program provided prescription drug coverage to more than 50 million people to determine the price that it will pay for each drug medicaid uses the average private sector price when medicaid is a large part of the demand for a drug this creates an incentive for its maker to increase prices for other health care consumers using drug utilization and expenditure data for the top 200 drugs in 1997 and in 2002 we investigate the relationship between the medicaid market share mms and the average price of a prescription our estimates imply that a 10 percentage point increase in the mms is associated with a 7 to 10 percent increase in the average price of a prescription in addition the medicaid rules increase a firm s incentive to introduce new versions of a drug in order to raise price we find empirical evidence that firms producing newer drugs with larger sales to medicaid are more likely to introduce new versions taken together our findings suggest that government procurement rules can alter equilibrium price and product proliferation in the private sector

the effect of medicare part d on pharmaceutical prices and utilization prescription drug expenditures represent the most rapidly growing component of health care spending increasing from 5 percent of health care spending in 1980 to more than 10 percent by 2005 centers for medicare and medicaid services cms 2007a further almost 60 percent of all prescriptions in the united states are filled for beneficiaries of medicare medicaid and other government programs rapid innovation in new pharmaceuticals has contributed substantially to quality of life and longevity in the us frank lichtenberg 1996 these facts combined indicate that government procurement schemes are critical both in determining government expenditure on pharmaceuticals and in stimulating innovation of new treatments in this paper we show that the institutions and mechanisms used by the government to pur chase prescription drugs can strongly affect market outcomes by institutions we have in mind large buyer groups structured incentives for patients to consume certain products and the devel opment and use of formularies a formulary is a mechanism that allows a buyer to identify a therapeutically similar treatment as a viable substitute for a patented treatment and to create price competition due to the ability to substitute away from the more expensive product when bargaining with the seller of a patented product the ability to shift demand to a substitute drug is a powerful negotiating tool our paper provides evidence for what we consider a surprising outcome in the case of the new prescription drug program for medicare enrollees moving consumers from cash paying status to membership in an insured group lowers optimal prices for branded prescription drugs below what they otherwise would be this is surprising because the standard effect of insurance is to create inelastic demand and therefore elicit higher prices from a seller with market power duggan and scott morton 2006 however the insurers that we study bundle insurance with a formulary and other mechanisms to create elastic demand an individual consumer typically does not know which drugs are acceptable therapeutic substitutes the consumer s physician typi cally has poor knowledge of prices especially negotiated prices and any one consumer is too small a share of demand to negotiate with a pharmaceutical company a prescription drug plan can potentially surmount all three hurdles our evidence leads us to conclude that the formulary and other mechanisms perform the spe cial role of allowing buyers to move market share among drugs with patent protection thereby raising cross price elasticities and lowering purchase prices or reducing price increases for branded drugs this result contrasts with the common intuition that an uninsured consumer

why did the ssi disabled program grow so much disentangling the effect of medicaid the number of participants in the ssi program grew by 1 1 million from 1987 to 1993 this paper examines the role of medicaid on the ssi participation decision i use the rapid growth in average medicaid expenditure as a proxy for its value ols estimates of medicaid s effect may be biased because of omitted variables bias and measurement error i therefore apply two stage least squares to estimate medicaid s effect using average medicaid expenditure for blind ssi recipients as an instrument these estimates show that rising medicaid expenditure significantly increased ssi participation among adults with low permanent incomes explaining 20 of the growth

intra industry trade and investment under oligopoly the role of market size this paper examines the factors which influence intra industry trade under oligopoly it argues that major determinants are the size of markets and the height of trade barriers if national markets are large and trade barriers high intra industry trade is replaced by cross investment between countries whereby firms serve the markets of their foreign rivals by investing abroad instead of exporting this result is established formally using a simple two country two firm game theoretic model the same model is also used to examine how barriers to trade influence prices and output the paper concludes with a brief discussion of how economic growth affects the volume of intra industry trade copyright 1992 by royal economic society

medicare part d are insurers gaming the low income subsidy design this paper shows how in medicare part d insurers gaming of the subsidy paid to low income enrollees distorts premiums and raises the program cost using plan level data from the first five years of the program i find multiple instances of pricing strategy distortions for the largest insurers instrumental variable estimates indicate that the changes in a concentration index measuring the manipulability of the subsidy can explain a large share of the premium growth observed between 2006 and 2011 removing this distortion could reduce the cost of the program without worsening consumer welfare

on exchange rates and economic growth abstract extending ireland s 1994 model this paper analyzes an international economy where cash or credit can be used for payment foreign trade credit is more costly than its domestic analog a depreciation of the real exchange rate is associated with an external surplus and a reduced share of imports purchased with credit economic growth slows when foreign trade credit becomes the predominant means of payment for international transactions a country with high inflation exports its tobin effect and thus temporarily increases world growth