Novel Contractual Arrangements in the Pharmaceutical Industry

这项研究计划的主要目标是开发一些数学模型来研究制药业中新的和重要的合同安排。我将集中讨论三个主要领域：1.制药公司和第三方付款人之间的风险分担合同；2.可用于增加低收入国家基本药物供应的合同；3.可用于确保高收入国家药品顺利供应的合同。上述三个领域的相似之处在于：1.它们都可能涉及付款人(如保险公司、政府医疗保健付款人或非政府组织(NGO))之间的合同；2.各种形式的“基于结果的”合同已被提出作为每一类问题的解决方案；3.听起来合理的政策建议可能会产生严重的意想不到的后果。对于每个小主题，我将调查付款人和制药公司(制造商)之间的一些拟议的和潜在的合同。这一分析的关键问题包括以下一些：各种合同结构可能产生的有意和无意的影响是什么？对于给定的合同结构，构建付款结构的最佳方式是什么？不同的合同结构在成本、绩效和其他有用指标方面的比较如何？请注意，主要关注点不是健康或健康提供。相反，重点是了解合同本身的结构和行为，以及它们如何影响参与合同各方的激励。

The primary objective of this program of research is to develop a number of mathematical models to study novel and important contractual arrangements in the pharmaceutical industry. I will focus on three main areas:1. Risk sharing contracts between drug companies and third-party payers;2. Contracts that could be used to increase the supply of essential medicines in low-income countries;3. Contracts that could be used to ensure smooth supply of medicines in high-income countries.The three areas identified above are similar in that: 1. They all may involve contracts between a payer (such as an insurance company, a government healthcare payer or a non-governmental organization(NGO); 2. Various forms of “outcomes based” contracts have been proposed as solutions for each type of problem; and 3. There may be serious unintended consequences from policy proposals that sound rational. For each subtopic I will investigate a number of proposed and potential contracts between payers and pharmaceutical companies (manufacturers). Key questions of this analysis include some of the following: What are the likely intentional and unintended effects of various contract structures? For a given contract structure, what is the optimal way to structure payments? How do different contract structures compare in terms of cost, performance, and other useful metrics? Note that the primary focus is not on health or health delivery. Rather, the focus is on understanding the structure and behavior of the contracts themselves, and how they influence the incentives of parties participating in the contracts.