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The biopharmaceutical industry has been a major driver of technological change in health care, producing unprecedented benefits for patients, cost challenges for payers, and profits for shareholders. As consumers and companies benefit from access to new drugs, policymakers around the globe seek mechanisms to control prices and expenditures commensurate with value. More recently the 1990s productivity boom of new products has turned into a productivity bust, with fewer and more modest innovations, and flat or declining revenues for innovative firms as generics replace their former blockbuster products. This timely volume examines the economics of the biopharmaceutical industry, with eighteen chapters by leading academic health economists. Part one examines the economics of biopharmaceutical innovation including determinants of the costs and returns to new drug development; how capital markets finance R&D and how costs of financing the biopharmaceutical industry compare to financing costs for other industries; the effects of safety and efficacy regulation by the Food and Drug Administration (FDA) and of price and reimbursement regulation on incentives for innovation; and the role of patents and regulatory exclusivities. Part two examines the market for biopharmaceuticals with chapters on prices and reimbursement in the US, the EU, and other industrialized countries, and in developing countries. It looks at the optimal design of insurance for drugs and the effects of cost sharing on spending and on health outcomes; how to measure the value of pharmaceuticals using pharmacoeconomics, including theory, practical challenges, and policy issues; how to measure pharmaceutical price growth over time and recent evidence; empirical evidence on the value of pharmaceuticals in terms of health outcomes; promotion of pharmaceuticals to physicians and consumers; the economics of vaccines; and a review of the evidence on effects of mergers, acquisitions and alliances. Each chapter summarizes the latest insights from theory and recent empirical evidence, and outlines important unanswered questions and areas for future research. Based on solid economics, it is nevertheless written in terms accessible to the general reader. The book is thus recommended reading for academic economists and non-economists, and for those in industry and policy who wish to understand the economics of this fascinating industry.
This volume examines the economics of the biopharmaceutical industry, with eighteen chapters by health economists.
The Oxford Handbook of Health Economics provides an accessible and authoritative guide to health economics, intended for scholars and students in the field, as well as those in adjacent disciplines including health policy and clinical medicine. The chapters stress the direct impact of health economics reasoning on policy and practice, offering readers an introduction to the potential reach of the discipline. Contributions come from internationally-recognized leaders in health economics and reflect the worldwide reach of the discipline. Authoritative, but non-technical, the chapters place great emphasis on the connections between theory and policy-making, and develop the contributions of health economics to problems arising in a variety of institutional contexts, from primary care to the operations of health insurers. The volume addresses policy concerns relevant to health systems in both developed and developing countries. It takes a broad perspective, with relevance to systems with single or multi-payer health insurance arrangements, and to those relying predominantly on user charges; contributions are also included that focus both on medical care and on non-medical factors that affect health. Each chapter provides a succinct summary of the current state of economic thinking in a given area, as well as the author's unique perspective on issues that remain open to debate. The volume presents a view of health economics as a vibrant and continually advancing field, highlighting ongoing challenges and pointing to new directions for further progress.
The pharmaceutical industry -- The biotechnology industry -- Generics and biosimilars -- The global pharmaceutical industry -- The demand for pharmaceuticals -- The demand for pharmaceuticals in major international markets -- Pharmaceutical prices -- Economic evaluation of new drugs -- Pricing pharmaceuticals in a world environment -- Pharmaceutical marketing -- Patent protection -- Drug approval process in the United States -- Pharmaceutical regulation in the European Union -- Pharmaceuticals and public policy : a look ahead
The prescription drug market -- Proposed solutions for rising drug prices -- Measuring the value of prescription drugs -- Measuring drug value : whose job is it anyway? -- Institute for Clinical and Economic Review (ICER) -- Other US value assessment frameworks -- Do drugs for special populations warrant higher prices? -- Improving value measurement -- Aligning prices with value -- The path forward.
This handbook showcases the broad spectrum of diverse approaches to environmental accounting which have developed during the last 30 years across the globe. The volume covers a range of physical issues such as water, carbon and biodiversity, as well as specific accounting matters such as management control, finance and audit. Moreover, seven chapters present environmental accounting issues that arise in the regions of Africa, Asia, Europe, MENA, North America, the Pacific and South America. The handbook also highlights future challenges in all the topic areas addressed as well as introducing new topics, such as links between environmental accounting and the circular economy, and the issues associated with animal rights. Edited by leading scholars in the area and with key contributions from across the discipline, and covering a diverse range of perspectives and locations, the volume is divided into five key parts: • Part 1: Framing the issues • Part 2: Financial accounting and reporting • Part 3: Management accounting • Part 4: Global and local perspectives • Part 5: Thematic topics in environmental accounting This handbook will act as a significant publication in drawing together the history of the field and important reference points in its future development, and will serve as a vital resource for students and scholars of environmental accounting and environmental economics.
This volume reviews the economic underpinnings (investment and financing) and institutional reforms needed to successfully scale up the education of health workers. In this regard, the book examines five major economic and institutional challenges that policy makers face: (1) governance of health education organizations and systems; (2) approaches to financing the education of health workers; (3) the special nature of capital investment in expanding the capacity of health education institutions; (4) public-private partnerships in health education; and (5) equity in accessing health education, with a special focus on issues that arise from private approaches to the education of health workers.Much of the existing literature focuses on the quality and contents of training health workers, and very little has been written on the institutional dimension of financing their training and education. This book examines the complex institutional and financial models and approaches that can impact the demand and supply of health worker education programs around the world.Building on the findings of the Independent Commission on the Education of Health Professionals for the 21st Century, which published on the foundations and the issues of global postsecondary professional education, this volume brings in new and in-depth aspects such as governance, capital investments, and the role of the private sector in the production of health professionals; thus allowing the reader to understand how the health worker education field has moved from theory to practice.
Perceptions that the pace of new-drug development has slowed and that the pharmaceutical industry is highly profitable have sparked concerns that significant problems loom for future drug development. This Congressional Budget Office (CBO) study-prepared at the request of the Senate Majority Leader-reviews basic facts about the drug industry's recent spending on research and development (R&D) and its output of new drugs. The study also examines issues relating to the costs of R&D, the federal government's role in pharmaceutical research, the performance of the pharmaceutical industry in developing innovative drugs, and the role of expected profits in private firms' decisions about investing in drug R&D. In keeping with CBO's mandate to provide objective, impartial analysis, the study makes no recommendations. David H. Austin prepared this report under the supervision of Joseph Kile and David Moore. Colin Baker provided valuable consultation...
"Beginning in the 1970s, several scientific breakthroughs promised to transform the creation of new medicines. As investors sought to capitalize on these Nobel Prize-winning discoveries, the biotech industry grew to thousands of small companies around the world. Each sought to emulate what the major pharmaceutical companies had been doing for a century or more, but without the advantages of scale, scope, experience, and massive resources. How could a large collection of small companies, most with fewer than 50 employees, compete in one of the world's most breathtakingly expensive and highly regulated industries? This book shows how biotech companies have met the challenge by creating nearly 40% more of the most important treatments for unmet medical needs. Moreover, they have done so with much lower overall costs. The book focuses on both the companies themselves and the broader biotech ecosystem that supports them. Its portrait of the crucial roles played by academic research, venture capital, contract research organizations, the capital markets, and pharmaceutical companies shows how a supportive environment enabled the entrepreneurial biotech industry to create novel medicines with unprecedented efficiency. In doing so, it also offers insights for any industry seeking to innovate in uncertain and ambiguous conditions. Looking to the future, it concludes that biomedical research will continue to be most effective in the hands of a large group of small companies as long as national healthcare policies allow the rest of the ecosystem to continue to thrive"--
This volume analyzes group purchasing organizations (GPOs) and pharmacy benefit managers (PBMs) in order to better understand the significant roles that these entities play in the healthcare supply chain. It examines who they contract with, on what terms, and who they represent and answer to while charting their historical development. The analysis reveals that the current roles of both players have historical roots that explain why they behave the way they do. Finally, the book reviews the evidence base on the performance results of these two players. This work fills a void in our understanding about two important and controversial players in the healthcare value chain. Both organizations are cloaked in secrecy — partly by virtue of the private sector contracts they negotiate, partly by virtue of the lack of academic attention. Both play potentially important roles in controlling healthcare costs, albeit using contracting strategies and reimbursement mechanisms that arouse suspicion among stakeholders. This timely text explicates how these organizations arose and evolved to shed more light on how they really operate.