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- April 20, 2023
- Article
Falling Insulin Prices—What Just Happened?
By: Leemore S. Dafny
Recently, more than 100 years after insulin was developed, manufacturers announced price reductions for insulin products. Pressure to reduce prices had long been building, so why would they act now?
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- September 2022
- Article
Giving a Buck or Making a Buck? Donations by Pharmaceutical Manufacturers to Independent Patient Assistance Charities
By: Leemore Dafny, Christopher Ody and Teresa Rokos
The federal Anti-Kickback Statute prohibits biopharmaceutical manufacturers from directly covering Medicare enrollees’ out-of-pocket spending for the drugs they manufacture, but manufacturers may donate to independent patient assistance charities and earmark donations...
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- June 9, 2023
- Article
A Radical Treatment for Insulin Pricing
By: Leemore S. Dafny
In 2021, the Food and Drug Administration (FDA) approved the first interchangeable biosimilar for long-acting insulin, which many hoped would be substantially cheaper than the reference branded product. I explain why prices have barely changed, and argue that a...
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- March 31, 2022
- Article
Two Approaches to Capping Health Care Prices
By: Michael E. Chernew, Maximilian J. Pany and Leemore S. Dafny
High health care prices for the privately-insured contribute to high premiums, which put downward pressure on wages, and induce employers to reduce benefit generosity and charge employees more for coverage. As the average annual premium for family coverage currently...
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- 2022
- Working Paper
How Do Copayment Coupons Affect Branded Drug Prices and Quantities Purchased?
By: Leemore S. Dafny, Kate Ho and Edward Kong
Drug copayment coupons to reduce patient cost-sharing have become nearly ubiquitous for high-priced brand-name prescription drugs. Medicare bans such coupons on the grounds that they are kickbacks that induce utilization, but they are commonly used by...
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- Article
Regulating Hospital Prices Based on Market Concentration Is Likely to Leave High-Price Hospitals Unaffected
By: Maximilian J. Pany, Michael E. Chernew and Leemore S. Dafny
Concern about high hospital prices for commercially insured patients has motivated several proposals to regulate these prices. Such proposals often limit regulations to highly concentrated hospital markets. Using a large sample of 2017 US commercial insurance claims,...
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- 2021
- Working Paper
Do Policies to Increase Access to Treatment for Opioid Use Disorder Work?
By: Eric Barrette, Leemore S. Dafny and Karen Shen
As of 2016 there were an estimated 2.1 million Americans suffering from opioid use disorder (OUD). To date, most policy interventions have focused on curbing opioid prescriptions and extending insurance coverage to include substance use disorder. However, relatively...
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- Article
The Covid-19 Pandemic Should Not Delay Actions to Prevent Anticompetitive Consolidation in U.S. Health Care Markets
By: Leemore S. Dafny
This article describes potential regulatory and legislative reforms to assist antitrust enforcement agencies in halting anticompetitive acquisitions and practices, and preserving and promoting competition in health care markets.
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- 2021
- Government Testimony
How Health Care Consolidation Is Contributing to Higher Prices and Spending, and Reforms That Could Bolster Antitrust Enforcement and Preserve and Promote Competition in Health Care Markets
By: Leemore S. Dafny
Reforms to antitrust law and enforcement can help to address rising healthcare prices and spending.
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- March 9, 2021
- Article
Addressing Consolidation in Health Care Markets
By: Leemore S. Dafny
This Viewpoint proposes three steps the Biden administration can take to slow consolidation within health care, which has been shown to raise costs without improving service or quality: better fund federal antitrust enforcement agencies; appoint agency heads committed...
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- 2020
- Working Paper
Vertical Integration of Healthcare Providers Increases Self-Referrals and Can Reduce Downstream Competition: The Case of Hospital-Owned Skilled Nursing Facilities
By: David Cutler, Leemore S. Dafny, David Grabowski, Steven S. Lee and Christopher Ody
The landscape of the U.S. healthcare industry is changing dramatically as healthcare providers expand both within and across markets. While federal antitrust agencies have mounted several challenges to same-market combinations, they have not challenged any...
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- August 14, 2020
- Comment
How Has COVID-19 Affected Health Insurance Offered by Small Businesses in the U.S.? Early Evidence from a Survey
As the COVID-19 pandemic stretches toward its third quarter, loss of health insurance coverage has not figured prominently in the public debate. Data in this report demonstrate why that is, but also suggest that the apparent stability is fragile, with potentially...
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- Article
Treatment Of Opioid Use Disorder Among Commercially Insured U.S. Adults, 2008–17
By: Karen Shen, Eric Barrette and Leemore S. Dafny
There is abundant literature on efforts to reduce opioid prescriptions and misuse, but comparatively little on the treatment provided to people with opioid use disorder (OUD). Using claims data representing 12–15 million nonelderly adults covered through commercial...
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- May 21, 2020
- Editorial
Primary Care Is Hurting: Why Aren't Private Insurers Pitching In?
By: Leemore S. Dafny and J. Michael McWilliams
Primary care clinicians are the front line for patients with suspected infection. We rely on them to diagnose, triage, and manage patients with potential or confirmed COVID infections. They are also responsible for keeping non-COVID medical conditions under control...
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- April 15, 2020
- Other Article
Designating Certain Post-Acute Care Facilities As COVID-19 Skilled Care Centers Can Increase Hospital Capacity And Keep Nursing Home Patients Safer
By: Leemore S. Dafny and Steven S. Lee
As the number of COVID-19 cases nationwide continues to grow, many hospitals will need to convert acute care beds into intensive care beds and discharge stable patients to post-acute care settings such as nursing homes. In addition, nursing homes unable to care for...
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- 2020
- Chapter
Health Care Markets a Decade After the ACA: Bigger, but Probably Not Better
By: Leemore S. Dafny
Love it or hate it, the Affordable Care Act (ACA) embraced and extended the role of private markets in financing and delivering health care in the United States. Ten years after the ACA’s passage, it is unclear whether health care markets are better (along a range of...
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- January 2, 2020
- Article
Changes in Quality of Care After Hospital Mergers and Acquisitions
By: Nancy Dean Beaulieu, Leemore S. Dafny, B. E. Landon, Jesse Dalton, Ifedayo Kuye and J. Michael McWilliams
Background: The hospital industry has consolidated substantially during the past two decades and at an accelerated pace since 2010. Multiple studies have shown that hospital mergers have led to higher prices for commercially insured patients, but research about effects...
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- Summer 2019
- Article
The Price Effects of Cross-Market Mergers: Theory and Evidence from the Hospital Industry
By: Leemore S. Dafny, Katherine Ho and Robin S. Lee
We consider the effect of mergers between firms whose products are not viewed as direct substitutes for the same good or service but are bundled by a common intermediary. Focusing on hospital mergers across distinct geographic markets, we show that such combinations...
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- February 2019
- Article
Does It Matter If Your Health Insurer Is For Profit? Effects of Ownership on Premiums, Insurance Coverage, and Medical Spending
By: Leemore S. Dafny
There is limited empirical evidence about the impact of for-profit health insurers on various outcomes. I study the effects of conversions to for-profit status by Blue Cross Blue Shield (BCBS) affiliates in 11 states, spanning 28 geographic markets. I find both the...
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