Modeling risk-sharing contracts

由于医疗保健支出是经济中最大的部分，主要由处方药支出驱动，我的研究计划将确定如何控制这些成本，同时改善消费者的健康状况。 本研究的动机是观察一种新型的合同应用在制药行业。加拿大、英国、澳大利亚和新西兰等国提出了各种形式的“风险分担”合同。然而，很少有研究从理论上探讨这种合同是如何设计的。本研究运用经济学、运筹学及数学的方法，探讨医药市场中不同契约的理论基础，并提供有关契约管理的管理见解。 我将考虑两种主要的合同形式：成本导向合同和结果导向合同。前者用于当药物的成本或其需求不确定时，而后者用于当药物的健康益处不确定时。合同规定了药品销售量或健康结果的阈值。我将开发一系列数学模型来研究在各种情况下，当药品支付者（如政府经营的保险计划和保险公司）和制造商（或几个制造商）谈判合同时，如何做出最佳决策。 现在，药品支出是许多国家医疗保健成本中增长最快的部分，风险分担合同对药品支付方控制成本非常重要。同样，它们对于改善病人健康和药品制造商谈判有利的合同条款至关重要。很少有论文从理论上研究风险分担合同在真实的世界中的应用。这项研究将有助于文献供应链管理作为一种新的方法在医疗保健部门和承包问题文献的发展，以解决这些问题的新技术。

With healthcare spending being the largest segment of the economy, largely driven by prescription drug expenditures, my research program will identify how these costs can be controlled while improving the health outcomes of consumers. This research is motivated by observing a novel type of contract applied in the pharmaceutical industry. "Risk-sharing" contracts have been proposed in various forms in countries including Canada, England, Australia and New Zealand. However, little research has theoretically investigated how such a contract is designed. This research applies methods in economics, operations research and mathematics to explore the theoretical basis of different contracts in the pharmaceutical market and to provide managerial insights regarding the management of contracts. I will consider two main contract forms: cost-oriented and outcome-oriented contracts. The former is used when the cost of a drug or its demand is uncertain while the latter is used when a drug's health benefit is uncertain. The contract specifies a threshold for the sales volume or health outcome of a drug. I will develop a series of mathematical models to investigate how optimal decisions are made when a drug payer, such as government-run insurance plans and insurance companies, and a manufacturer (or several manufacturers) negotiate a contract under various situations. Now that drug expenditures are the fastest growing segment of healthcare costs in many countries, risk-sharing contracts are important to drug payers to control costs. As well, they are vital to improve patient health and for drug manufacturers in negotiating favourable contract terms. Very few papers have theoretically investigated the application of risk-sharing contracts to the real world. This research will contribute to the literature on supply chain management as a novel approach in health-care sectors and for contracting problem literature on the development of new techniques to solve such issues.