Modeling risk-sharing contracts

由于医疗支出是经济中最大的部分，主要由处方药支出推动，我的研究计划将确定如何在控制这些成本的同时改善消费者的健康结果。 这项研究的动机是观察到一种适用于制药行业的新型合同。在加拿大、英国、澳大利亚和新西兰等国，人们以各种形式提出了“风险分担”合同。然而，很少有研究从理论上探讨此类合同是如何设计的。本研究运用经济学、运筹学和数学的方法，探讨医药市场不同合约的理论基础，并提供有关合约管理的管理见解。 我将考虑两种主要的合同形式：注重成本的合同和注重结果的合同。前者是在药物成本或需求不确定的情况下使用，而后者是在药物的健康益处不确定的情况下使用。合同规定了药品销售量或健康结果的门槛。我将开发一系列数学模型来研究当药品付款人，如政府运营的保险计划和保险公司，与制造商(或几家制造商)在各种情况下谈判合同时，如何做出最优决策。 现在，药品支出是许多国家医疗费用中增长最快的部分，风险分担合同对药品支付者控制成本很重要。此外，它们对于改善患者健康和药品制造商在谈判有利的合同条款方面也至关重要。很少有论文从理论上研究风险分担合同在现实世界中的应用。这项研究将有助于编写关于供应链管理作为保健部门一种新方法的文献，以及关于开发解决此类问题的新技术的问题文献。

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.