<p>The dissertation consists of three chapters relating to pricing strategies. Chapter 1 studies coupons for prescription drugs and their impacts on consumer welfare, firm profits, and insurance payments. Chapter 2 examines consumer brand loyalty and learning in pharmaceutical demand and discusses implications for marketing and health care policy. Chapter 3 develops a framework for estimating demand and supply in an online market with many competing sellers and frequent price changes and proposes optimal pricing strategies for a large seller.</p><p>The first chapter studies an innovative price strategy in pharmaceuticals. Branded drug manufacturers have recently started to issue copay coupons as part of their strategy to compete with generics when their branded drugs are coming off patent. To explore the welfare implications of copay coupons, I estimate a model of demand and supply using pharmaceutical data on sales, prices, advertising, and copayments for cholesterol-lowering drugs and perform a counterfactual analysis where a branded manufacturer introduces coupons. The model allows flexible substitution patterns and consumer heterogeneity in price sensitivities and preferences for branded drugs. The counterfactuals quantify the effects of copay coupons for different assumptions about the take-up of coupons and the ability of the branded manufacturer to direct them to the most price-sensitive types of consumers. The results show that the agency problem between insurers and patients gives a branded manufacturer a strong incentive to issue copay coupons. Introducing copay coupons benefits the coupon issuer and consumers but raises insurance payments. In equilibrium, insurer spending can increase by as much as 25% even when just 5% of consumers have a coupon, with social welfare falling significantly.</p><p>Medicines for chronic conditions like high cholesterol, heart disease, and diabetes are repeatedly used for a long period of time. Consumer dynamics thus plays an important role in the demand for those drugs. In the second chapter, I estimate a demand model with brand loyalty and learning using micro-level data from cholesterol lowering drug markets in the United States. The estimates suggest high switching costs and strong learning effects at the molecule level in the markets. Switching costs raise the predicted probability of choosing the same drugs in a row and learning largely increases patient stickiness to a molecule in the long run. I discuss pricing implications of the estimation results for drug manufacturers, insurance companies, and policy makers. </p><p>The last chapter, coauthored with Dr. Andrew Sweeting and Dr. James W. Roberts, looks at pricing in a different context. We estimate a model of entry, exit and pricing decisions in an online market for event tickets where there are many competing sellers and prices change frequently. We use the estimates from our model to analyze the optimality of the pricing policy used by the largest seller (broker) in the market. We show that the broker's pricing policies substantially affect the prices set by his competitors. When we compare the broker's pricing policy with the prices that our model predicts are optimal we find that the broker sets approximately correct prices close to the game, when his pricing problem resembles a static one, but that he might be able to gain from using different pricing rules and updating prices more frequently further from the game.</p> / Dissertation

Purpose ¿ The purpose of this study is to investigate the customer's perception of service quality within the context of the pharmaceutical supply chain, and look specifically at the supplier/customer relationship. Design/methodology/approach ¿ The research in question focuses on the trading relationship between a pharmaceutical wholesaler and its pharmacy customers. Existing literature shows that quality of the overall service is determined by the customer's perceptions of that service; therefore it is important that the supplier measures the customer's perception of service quality and understands what factors influence that perception and build this into their service delivery. The data were collected via a series of qualitative semi-structured interviews with hospital and retail pharmacies located in the North West of England. Findings ¿ The findings show that pharmacy customers have a range of vitally important to less important criteria associated with good service quality and that pharmaceutical wholesalers as suppliers should aim to excel at the vital and important issues and meet those of lesser importance to satisfy customers expectations of service quality. Research implications/limitations ¿ This reinforces the importance of measuring customer expectations and incorporating outputs into service design to ensure a customer focus to the service provided. Further consideration should be given to adopting the SERVQUAL tool in conducting future research and analysis. Practical implications ¿ Suppliers should be aware that there are vital activities that customers expect to have performed/delivered and that they need to know what these are and excel at these, whilst managing less important criteria effectively. Originality/value ¿ This paper provides an insight into the customer-supplier relationship within the pharmaceutical supply chain in the NHS, which will be of benefit to practitioners and academics in this field.

Purpose ¿ This paper aims to examine the role of e-commerce in hospital pharmacy in the procurement of pharmaceuticals and determine how this has improved the internal pharmaceutical supply chain. Whilst e-commerce is in its infancy in this area it is still considered to be an important facet of supply chain management. E-trading within NHS pharmacies is conducted via electronic data interchange (EDI) offering proven benefits and ensuring the efficient and effective transmission of data between remote parties. Design/methodology/approach ¿ The data were collected via a case-study in an NHS trust pharmacy supported and by questionnaires distributed to NHS and community pharmacies in the north-west of England. Findings ¿ The findings support the view that there are benefits to be gained from introducing EDI into a purchasing department as the next logical step towards a total e-commerce solution (internet-based) and instigating quality improvements. It also proposes that the implementation and use of e-commerce in hospital pharmacies can be aligned with progress made in small- to medium-sized enterprises (SMEs), and questions why, if such benefits can be realised, the use of e-commerce systems are not more widespread. Research limitations/implications ¿ The implications of this research is that it offers a ¿snap-shot¿ of progress made-to-date of e-commerce in NHS Pharmacy, which can provide guidance for mangers and healthcare professionals managing their e-commerce/quality improvement agenda. The research conducted was restricted to a specific regional area of the NHS and could be applied to a larger national sample group. Future research within this field should also consider the cost of not introducing e-commerce in pursuing quality improvement. Originality/value ¿ This discussion offers an insight into how a pharmacy approached EDI, and this is further supported by recent research conducted into examining the pharmacy systems in operation in the north-west of England and accompanying EDI systems and an analysis of EDI uptake and use in a sample of pharmacies in the same region, the latter being supported by anecdotal evidence of pros and cons to using EDI and potential barriers to its introduction.

This thesis describes the development and application of solid phase microextraction (SPME) as a sample preparation technique for in vivo determination of pharmaceutical residues in fish tissue and wastewater. The occurrence, distribution and fate of pharmaceuticals in the environment are a subject of concern across the globe due to the impact they may have on human life and aquatic organisms. To address this challenge from an analytical perspective, a simplified and reliable analytical methodology is required to investigate and determine the concentration (bioconcentration factors) of trace pharmaceutical residue in fish tissue and environmental water samples (exposure). An improved SPME method, coupled with liquid chromatography with tandem mass spectrometry has been developed and applied to both controlled laboratory and field-caged fish exposed to wastewater effluent for quantitative determination of pharmaceutical residue in fish specific tissue. A new SPME configuration based on C18 thin film (blade) was developed and optimized to improve SPME sensitivity for in vivo determinations of trace pharmaceuticals in live fish. The C18 thin film extraction phase successfully quantified bioconcentrated fluoxetine, venlafaxine, sertraline, paroxetine, and carbamazapine in the dorsal-epaxial muscle of living fish at concentrations ranging from 1.7 to 259 ng/g. The reproducibility of the method in spiked fish muscle was 9-18% RSD with limits of detection and quantification ranging from 0.08 - 0.21 ng/g and 0.09 - 0.64 ng/g (respectively) for the analytes examined. Fish were sampled by in vivo SPME for 30 min to detect pharmaceutical uptake and bioconcentration, with experimental extracts analyzed using liquid chromatography coupled with tandem mass spectrometry. In addition, a simplified analytical methodology based on SPME was developed and optimized for determination and bioconcentration factor of different classes of pharmaceuticals residues in fish bile. The reproducibility of the method in spiked fish Rainbow Trout bile was 3-7% RSD with limits of detection (LOD) ranging from 0.3 – 1.4 ng/mL for the analytes examined. The field application of SPME sampling was further demonstrated in Fathead Minnow (Pimephales promelas), a small-bodied fish caged upstream and downstream of a local wastewater treatment plant where fluoxetine, atorvastatin, and sertraline were detected in fish bile at the downstream location. Also, a simple automated analytical method using high throughput robotic system was developed for the simultaneous extraction of pharmaceutical compounds detected in surface waters. The proposed method successfully determined concentrations of carbamazepine, fluoxetine, sertraline, and paroxetine in treated effluent at concentrations ranging from 240 - 3820 ng/L with a method detection limit of 2-13 ng/L, and a relative standard deviation of less than 16%. Application of the method was demonstrated using wastewater from pilot-scale municipal treatment plants and environmental water samples from wastewater-dominated reaches of the Grand River (Waterloo, ON). Finally, 4 and 8-d laboratory exposures were carried out with Rainbow Trout exposed to wastewater effluent collected from pilot scale at Burlington, ON. Additionally, wild fish, White Sucker (Catostomus commersonii) were collected and sampled from Waterloo and Kitchener downstreams containing local municipal effluent. Bioconcentration factors of the selected compounds were determined in both fish muscle and bile samples. The results show that anti-depressant drugs such fluoxetine, sertraline and paroxetine were uptake in the fish muscle and fish bile for both laboratory and field exposure. In summary, exposure of fish to micro-pollutants such as pharmaceuticals may be monitored through the analysis of bile, particularly at low concentration exposure of pharmaceuticals, where the sensitivity of analytical method may be challenged. SPME is a promising simple analytical tool which can potentially be used for monitoring of pharmaceuticals in fish tissue and wastewater.

This thesis consists of three independent essays, unified by the common theme of the distributional impacts of government. The first paper estimates the price elasticity of demand for pharmaceuticals amongst high-income older people in Australia. It exploits a natural experiment by which some people gained entitlement to a price reduction through the Commonwealth Seniors Health Card (CSHC). The preferred model is a nonlinear Instrumental Variable (IV) difference-in-difference regression, estimated on repeated cross sectional survey data using the Generalised Method of Moments. No significant evidence is found for endogenous card take-up, and so cross-sectional estimates are also considered. Taking all of the results and possible sources of bias into account, the ??headline?? estimate is -0.1, implying that quantity demanded is not highly responsive to price. The elasticity estimate is a key input into the second paper which analyses the distributional impact of the CSHC. I consider the trade-off between moral hazard and risk pooling. There have been few previous attempts internationally to address this trade-off empirically for any health insurance scheme. The utility gain through risk-pooling is found to be negligible. However, the deadweight loss through moral hazard may be considerable. I also use an illustrative model to demonstrate the possible effects of the CSHC on inter-temporal savings behaviour. While the CSHC may induce some people to save, it may have the opposite effect on others. The net impact was not determined. The third paper estimates the Australian public sector wage premium. It includes a detailed critical review of the methods available to address this issue. The chosen approach is a quasi-differenced panel data model, estimated by nonlinear IV, which has many advantages over other methods and has not been used before for this topic. I find a positive average public sector wage premium for both sexes. The best estimates are 10.0% for men and 7.1% for women. The estimate for men is statistically significant (p < 0.04) and borders on significance for women (p < 0.07). No evidence is found to suggest that the public sector has an equalising effect on the wages of its workers.

Diss. Uppsala : Univ., 2004.

Diss. Stockholm : Handelshögskolan i Stockholm, 2008.

Innovation is generally regarded as an essential aspect of the economic growth for a country. Intellectual property rights such as patents are often held in the same regard of importance towards promoting the pursuit of innovation. This paper examines this assumption and explores whether patent applications positively or negatively influence GDP growth in a sample of 4 countries chosen for their similarity in stages of economic development. In my research, I also test for the influence of patent applications on commercialized innovation. I find that GDP growth and commercialized innovation are negatively affected by patent applications. This suggests that the commonly assumed link between patents and innovation may need to be reevaluated, and that using patents as an indicator of the economic growth of a country may also need to be reevaluated.

No description available.

Para que sejam atendidos os requisitos normativos e reguladores dentro dos padrões nacionais e internacionais que tratam das condições inerentes à produção-processamento de materiais sensíveis à contaminação, tais como medicamentos injetáveis, um ambiente com atmosfera controlada deve ser criado. Tratando-se de materiais que têm aplicação medicinal, através de procedimentos específicos, mas que também apresentam em suas constituições agentes tóxicos, radioativos e periculosos, o ambiente deve assegurar que estes materiais, que em alguns casos possuem ainda característica de serem voláteis, não escapem para meio ambiente, sem que isto ocorra de uma maneira seletiva e segura, totalmente controlada. A condição de trabalho neste caso, recomendada pelas normas nacionais e internacionais vigentes, refere-se a uma atmosfera negativa em relação aos ambientes adjacentes. Apesar de a literatura estar amplamente provida de tecnologias referentes ao dimensionamento de sistemas, baseados em normas que determinam claramente os requisitos necessários, verifica-se a necessidade de desenvolver um ambiente controlado para produção de radiofármacos, compatibilizando o conceito de área limpa aos requisitos de segurança para manipulação de fontes radioativas abertas. Neste trabalho, dispositivos foram criados, métodos e procedimentos estabelecidos, com objetivo de possibilitar classificações diferentes do ar no interior da cela, sem barreiras físicas na área de trabalho, estabelecendo uma condição ergonômica, flexível e prática, refletindo em maior produtividade. O projeto resultou na criação de um ambiente totalmente favorável ao pronto atendimento dos requisitos normativos, composto de uma câmara de passagem responsável pela entrada e saída de material, sem que condições internas ao micro-ambiente fossem comprometidas. A estanqueidade da cela foi obtida utilizando-se portas dotadas de sistema eficiente de vedação através de juntas ativas e intertravamentos. Manipuladores tipo pinça asseguraram as operações de maneira ergonômica e segura, sem comprometer a estanqueidade e classificação do ambiente com graus de limpeza A e B. Para isso, utilizou-se um eficiente sistema de ventilação/ exaustão, dotado de filtros e dispositivos especiais desenvolvidos com exclusividade para que as condições impostas ao micro ambiente fossem estabelecidas a contento. Todos os parâmetros de funcionamento da cela foram avaliados através do planejamento de ensaios específicos. Os resultados dos ensaios demonstraram o atendimento aos critérios estabelecidos, indicando o potencial do projeto para o desenvolvimento de uma cela de produção de radiofármacos. / A controlled ambient should be established to the production/processing of materials susceptible to contamination, like injectable pharmaceuticals, in order to agree with normative and regulatory requirements. Considering medical but also toxic, radioactive and dangerous products, the ambient should work in special conditions to assure that the materials, which in same cases can be also volatile, do not escape to the external ambient, working in a selective, secure and controlled way. The conditions recommended by local and international rules in use, report an negative pressured ambient in relation to the adjacent areas. The technology related with the sizing of project to this kind of system is fully described in the literature, taking in account the rules that clearly describe the essential requirements. However, it is necessary to develop a controlled ambient for radiopharmaceutical production, in a way compatible with the concept of clean rooms and with the safety related to the manipulation of open radioactive wastes. In this work, some devices were created, methods and procedures were established making possible the classification of the ambient inside the hot cell, without physical barriers in the area, using ergonomic, flexible and practical conditions of work, that can results in the improvement of the productivity. The project resulted in the creation of a controlled ambient, in agreement with the normative requirements, using a pass through for entrance and exit of the materials, without compromise the internal air condition. The tight of the hot cell was obtained using doors with efficient sealing system and active joints. Tong manipulators were used to produce ergonomic and secure conditions, without compromise the internal conditions related to tight and classification in A and B grade, according to local and international rules. An efficient ventilation/exhaustion system was adopted to produce these results, composed by filters and special devices, developed exclusively to produce ideal conditions in the micro ambient. All the operational parameters of the cell were investigated by planning specific assays. The results of these assays were in agreement with the criterions established and indicated the potential of the project in the development of a hot cell for radiopharmaceutical production.