EconPapers    
Economics at your fingertips  
 

Hospital payment schemes and high-priced drugs: Evidence from the French Add-on List

Laurie Rachet-Jacquet, Lea Toulemon and Lise Rochaix

Health Policy, 2021, vol. 125, issue 7, 923-929

Abstract: Under prospective payment schemes, hospitals may be disincentivised to use high-priced drugs. In this context, supplementary payment schemes have been implemented to fund hospitals beyond hospital tariffs for the use of such technologies. In France, since 2004, an add-on list scheme ensures that listed high-priced drugs are reimbursed by the state, thereby imposing no cost on hospitals while drugs are on the list. Yet little is known about the impact of drug delisting, i.e., when drugs are removed from the add-on list, on hospital utilisation. In this paper, we investigate the effects of delisting for 12 cancer drugs on the volumes prescribed, the generic shares and the purchase prices negotiated by hospitals. Using French hospital-level data over the period 2008-2016, we construct volumes, generic shares and purchase prices at the molecule level to account for potential substitutions across therapeutically equivalent drugs. Hospital fixed effects allow for time-invariant unobserved hospital heterogeneity linked to e.g., prescription preferences or hospitals’ bargaining power. Our results indicate that prescription volumes, generic shares and price levels are not systematically affected by delisting, nor do we find evidence of response heterogeneity by hospital type. Overall, our findings mitigate concerns that the financial incentives associated with add-on lists may lead to hospitals over-prescribing high-priced drugs.

Keywords: High-priced drugs; Hospital prospective payments, Add-on lists (search for similar items in EconPapers)
Date: 2021
References: View references in EconPapers View complete reference list from CitEc
Citations:

Downloads: (external link)
http://www.sciencedirect.com/science/article/pii/S016885102100110X
Full text for ScienceDirect subscribers only

Related works:
Working Paper: Hospital payment schemes and high-priced drugs: Evidence from the French Add-on List (2021)
Working Paper: Hospital payment schemes and high-priced drugs: Evidence from the French Add-on List (2021)
Working Paper: Hospital payment schemes and high-priced drugs: Evidence from the French Add-on List (2021)
This item may be available elsewhere in EconPapers: Search for items with the same title.

Export reference: BibTeX RIS (EndNote, ProCite, RefMan) HTML/Text

Persistent link: https://EconPapers.repec.org/RePEc:eee:hepoli:v:125:y:2021:i:7:p:923-929

DOI: 10.1016/j.healthpol.2021.04.012

Access Statistics for this article

Health Policy is currently edited by Katrien Kesteloot, Mia Defever and Irina Cleemput

More articles in Health Policy from Elsevier
Bibliographic data for series maintained by Catherine Liu () and ().

 
Page updated 2025-03-23
Handle: RePEc:eee:hepoli:v:125:y:2021:i:7:p:923-929