[pt] O propósito desse estudo é analisar as estratégias competitivas implementadas por empresas da indústria farmacêutica brasileira. Este trabalho adota como base o estudo de Chrisman sobre tipologias, identificando as estratégias relevantes e os grupos existentes nessa indústria, relacionando o posicionamento estratégico adotado pelos laboratórios com seu desempenho no setor. Além disso, a pesquisa busca analisar impactos do advento dos genéricos nessa indústria. O método de análise utilizado constituí- se do levantamento de uma base de dados obtida a partir de relatórios de consultorias especializadas, da identificação de variáveis estratégicas e de desempenho e da implementação de procedimentos estatísticos. Os posicionamentos e desempenhos identificados entre os anos de 1999 e 2002 sugerem a adoção de redução de custos como arma estratégica, ao contrário do que acontecia antes no mercado, onde havia um foco maior em diferenciação. O estudo também sugere que os grandes laboratórios ainda conseguem obter um desempenho superior baseados em suas marcas reconhecidas e grande escala de operação, enquanto os laboratórios nacionais, de menor porte, estão investindo cada vez mais no segmento de medicamentos genéricos. / [en] The aim of this study is to analyze the competitive strategies implemented by Brazilian pharmaceutical companies. This research is based on Chrisman s studies on strategic typologies, identifying the relevant strategies and the existing groups in this industrial sector. The study also relates the strategic positioning of the pharmaceutical companies to the achieved performance and analyzes the impact of the generic drugs launching in the sector. The methodology adopted is based on the analysis of collected database from reports of specialized consulting companies, the survey of strategy and performance indicators, as well as the implementation of statistical procedures. The relation of positioning and performance identified in the period between the years 1999 and 2002 suggests a movement to adoption of cost strategy, against the differentiation oriented focus of the industrial sector before the generic drugs launching. The results also suggest that the great companies are still able to have a superior performance due to their well known marks and operation scale, while smaller companies tend to invest in the generic drugs segment.

This thesis consists of two parts. The first part includes two essays that deal with the pharmaceutical market, and one essay that looks at strategic incentives that arise in optimal treatment involving untried drugs. The second part, consisting of two essays, examines some implications of altruism. Part I: Two of the essays (joint with Mats Ekelund) are empirical studies of the pharmaceutical market in Sweden. We consider all New Chemical Entities (NCEs) introduced in Sweden between 1987 and 1997. In the first essay, we examine drug pricing in the price regulated Swedish market and compare the results with a previous study of the US market, where no such regulation exists. Similar to the US study, we find that relative launch prices are positively correlated with the degree of therapeutic advance. In contrast to the US study, the presence of substitutes has a negligible effect on both launch prices and price dynamics. In the second essay, we consider the empirical relation between therapeutic advance and market shares. We use a model of horizontal and vertical product differentiation to derive a hypothesis that is tested on the NCE data. Vertically differentiated drugs on average gain larger market shares and command higher prices than horizontally differentiated drugs. Moreover, as a general rule competing substitutes have less influence on the former than on the latter. In the third essay, we develop a simple model of strategic interaction in which two agents learn about a common payoff relevant parameter. The motivating example considers two physicians who choose between two treatments, one of which has an unknown success rate. The physicians learn about the unknown treatment by prescribing it (experimenting). We contrast two information scenarios, one in which the physicians can observe the outcomes of their own treatments only, and the other in which they also can observe the outcomes from the other physician’s treatments. The pure equilibria entail an efficient amount of experimentation in both scenarios. However, strong free riding effects arise in the latter case. These are likely to cause Pareto dominated outcomes in which learning is completely thwarted. Part II: The fourth essay (joint with Jörgen W. Weibull) examines the behavior on insurance markets in a large economy when individuals have altruistic concerns for others’ welfare. The main question we address is whether strategic incentives to free ride on others’ altruism can cause insurance market failure. We also study the interaction between altruism and the adverse selection effects that arise when there is asymmetric information about the individuals’ loss probabilities. We find that if the individuals differ in their risk, and if the individual risks are observable by insurers, the degree of altruism must be (perhaps unrealistically) high in order to cause market failure. A more complex pattern is found in the case of asymmetric information: low levels of altruism increase the number of equilibria (compared to the case without altruism), while high levels of altruism cause complete market failure. The fifth essay (joint with Magnus Johannesson) also considers behavior consistentwith preferences for others’ welfare. We are concerned with how subjects allocate moneybetween themselves and others in a dictator game experiment. Deviations from the standard game theoretic prediction of the outcome in this game have been observed in numerous experiments. One possible explanation for this behavior is that individuals have altruistic concerns for others; another explanation is that individuals are motivated by reciprocity. We perform a standard double blind procedure and another design in which anonymity is guaranteed between dictators and recipients, thus removing any remaining reciprocity from the standard procedure. We could not reject the null hypothesis of no difference between the experimental groups in the two procedures. We interpret this finding as evidence of other-regarding behavior not motivated by reciprocity. / Diss. Stockholm : Handelshögskolan, 2001

The pharmaceutical industry is one of Sweden’s most important export industries with 6% of total exports. The purpose of this thesis is to analyse which factors affect Sweden’s ex-port of pharmaceutical products. Further, the different pharmaceutical products group Sweden exports will be identified. The modern trade theory, the monopolistic competition model, the product life cycle theory and the gravity equation are used to explain and to un-derstand the problem at hand. To analyse the problem, data of Swedish export of pharmaceutical products from 1997 to 2003 was used to the 176 destination countries Sweden exported to during the time period. The following factors were used as independent variables; distance, Gross Domestic Prod-uct (GDP) /capita, Area, Population, dummy variable for EU-membership, dummy vari-able for English or Scandinavian speaking countries, dummy variable for bordering to Sweden, dummy variable for same religion as Sweden and a dummy variable for countries that are not land-locked. The findings coincide with previous studies in the manner that distance and GDP/capita have a major impact on the sales abroad of pharmaceutical products. Also, countries with a larger population are importing more than countries with a smaller population. However, the strong affinities between the exporter and the importing countries found in previous studies were not found in the export of pharmaceutical products. Further, Sweden exports most of the product group that includes medicaments consisting of mixed or unmixed products for therapeutic or prophylactic uses. / Läkemedelsindustrin är en av Sveriges viktigaste exportindustrier med 6 % av den totala exporten. Syftet med denna uppsats är därför att analysera vilka faktorer som påverkar dess export. Vidare, de olika exportgrupperna av läkemedel som Sverige exporterar kommer att identifieras. Den moderna handelsteorin, monopolistisk konkurrens, produktcykelteorin och gravitationsmodellen används för att förklara och förstå det uppstådda problemet. För att analysera problemet så används Sveriges export av läkemedel från 1997 till 2003 för alla 176 destinationer. Följande faktorer används som oberoende variabler; distansen, BNP/capita, arean, folkmängd, dummy variabel för EU-medlemskap, dummy variabel för engelsk- eller skandinaviskspråkiga länder, dummy variabel för gränsande länder till Sverige, dummy variabel för länder som har samma religion som Sverige, samt en dummy variabel för länder som angränsar till vatten. Resultatet överensstämmer med tidigare forskning att avståndet och BNP/capita har ett stort inflytande av exporten av läkemedel. Likaså länder med ett stort invånarantal importe-rar mer än länder med ett mindre invånarantal. Däremot, det starka släktskapet mellan ex-portören och de importerande länderna som funnits i tidigare studier observerades inte i exporten av läkemedel. Vidare, Sverige exporterar mest av produktgruppen som innehåller medikamenter bestående av blandade eller oblandade produkter för terapeutiskt eller profy-laktiskt bruk.

<p>In this dissertation, I study medicalization, a wide spread phenomenon in this world but understudied in the current literature. The main theoretical focus of this dissertation is on expanding the medicalization theories. Questioning the breadth of conceptualization, the feasibility of measurement, and the depth of empirical implications in the extant medicalization theories, this dissertation proposes a new conceptual model of medicalization and further develops a quantitative measure of medicalization by disaggregating it into empirically valid dimensions that could be used to examine how degree of medicalization is related to social outcomes. Specifically, I conceptualize medicalization as an institutionalization process whereby the medical model becomes increasingly dominant in the explanation of health, illness, and other human problems and behavior. Medicalization is multidimensional and is represented by expansions in the three major components of the health care system: increasing medical investment, medical professionalization/specialization, and the relative size of the pharmaceutical industry. </p><p>Based on this new conceptual model and measurement, I probe three research questions: (1) how medicalization may impact population health in the context of recent epidemiologic transitions and how this impact may differ by the stages of epidemiologic transition and socioeconomic development; (2) what are the mechanisms that reproduce medicalization; and (3) how the lay public may respond to medicalization, the institution of medicine, and the medical profession.</p><p>This dissertation links several lines of theoretical and empirical research from medical sociology, demography, epidemiology, health economics and management, and medical science, and extensively employs OECD Health Data, World Development Indicators, the World Values Survey, the European Values Study data, the U.S. General Social Survey, and the U.S. National Health Interview Survey. It uses several advanced statistical methods, e.g., multiple imputations, latent variable analysis, mixed models, generalized estimating equations models, generalized method of moments models, difference-in-difference models, and hierarchical-age-period-cohort models.</p><p>Results for the first research question suggest that various dimensions of medicalization vary in importance on population health and these effects also differ by the stages of epidemiologic transition and socioeconomic development. I discuss the mechanisms linking various dimensions of medicalization to population health and then discuss these findings in the context of epidemiologic transition, fundamental causes of disease and death, and global health movement. </p><p>Results for the second research question suggest that medicalization at both the societal and individual levels negatively affect individual subjective health, which leads to increasing health care utilization. These social processes function together to promote and reproduce medicalization at societal level. I discuss several pathways linking medicalization to lower subjective health and other agents of medicalization.</p><p>Results for the third research question suggest that American's "confidence in the medical institution and profession" has continuously declined in the last three decades and groups with higher socioeconomic status report lower obedience to doctors' authority, but are more likely to trust doctors' ethics than their counterparts. I discuss the mechanisms for the changes in public confidence in the medical institution and profession, the status of medicine and the medical profession in the era of medicalization, the paradox of opposite trends in attitudes toward medicine and health utilization behavior, and group differences in obedience and trust.</p> / Dissertation

The Swedish pharmaceutical industry is going through structural changes due to the increased cost of drug development. This has led pharmaceutical firms to outsource clinical trials to Clinical Research Organisations (CRO). This thesis explores the inter-firm relationships between pharmaceutical firms and CROs in the Stockholm area, with focus on the development of trust and commitment. The empirical material gathered from nine qualitative interviews with representatives from both parties suggests that trust and commitment are both important factors. Trust is based on competence and reputation whilst commitment is developed through communication. Commitment is highly valued by the companies that wished to develop long-term relationships. The results also point to challenges in the area mainly regarding patient recruitment that due to the high competition amongst the CROs can lead to opportunism when they are overly optimistic of what they can deliver. This is an issue that needs to be addressed as it affects the whole industry.

University of Macau / Institute of Chinese Medical Sciences

University of Macau / Institute of Chinese Medical Sciences

University of Macau / Institute of Chinese Medical Sciences

University of Macau / Institute of Chinese Medical Sciences

Measuring marketing effectiveness is critical for marketers as the pharmaceutical industry is under great pressure for cost control. Pharmaceutical marketers need to optimally allocate these resources and ensure that they achieve the highest possible return on investment for the firm. Pharmaceutical manufacturers utilize a variety of marketing vehicles to promote their products to physicians and consumers. At the physician level, effects of detailing are typically identified to be positive. Direct- to-consumer advertising does impact the choice probability, but the impact of promotions aimed directly at physicians is significantly higher. Measuring value of marketing activities is important for a company to achieve a profit margin and best allocate its resources. To define and deliver quantitative measurements that justify how investment in specific marketing programs are paying off, marketers need metrics to show that their programs work. Then, selected metrics should be meaningful and related to financial performance. There are a few metrics regularly used by marketers such as brand awareness, market share, consumer attitudes toward brand, purchase intention, return on investment, lifetime value of an activity, and brand equity. The paper uses a case study to review and evaluate the effectiveness of a marketing plan for a new launch product. Specifically, return on investment (ROI) for patient programs and lifetime value of activity (LVA) for physician education programs were calculated in the case study. A company is able to increase sales profit by reallocating resources to activities with higher ROI and LVA. To conclude, marketers need to identify meaningful metrics, set up a tracking process, and regularly follow up all relevant marketing activities. The process of measuring marketing effectiveness through the tracking process will help companies to understand how the marketing activities work and whether these programs deliver profitable value growth. The follow up action to fine-tune budget plans can then optimize return of marketing investment and maximize profitability.