Who Pays, Who Benefits? Producer-Insurer Games in Life-Saving Medicines

Fuente: arXiv
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Main Authors: Coculescu, Delia, Janisch, Maximilian, Lehéricy, Thomas
Format: Preprint
Published: 2025
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author Coculescu, Delia
Janisch, Maximilian
Lehéricy, Thomas
author_facet Coculescu, Delia
Janisch, Maximilian
Lehéricy, Thomas
contents Pharmaceutical markets for life-saving therapies combine monopoly power with insurance coverage. We build a tractable sequential game in which a patent-holder chooses the drug price, a profit-maximising insurer sets its premium, and a population of heterogeneous agents decide whether to insure and, conditional on diagnosis, whether to purchase treatment. Two sufficient statistics - subjective illness probability and reservation price - capture heterogeneity and nest risk-aversion and liquidity-constraint motives within a unified framework. We prove existence of subgame-perfect Nash equilibria and show that entry of an insurer strictly raises producer profits but may raise or lower both drug prices and treatment uptake, depending on the joint distribution of the population statistics. Numerical experiments calibrated to flexible parametric families illustrate non-monotone comparative statics and quantify conditions under which insurance reduces access. Our results provide benchmarks for evaluating price negotiations, price caps, and subsidy schemes in high-cost drug markets.
format Preprint
id arxiv_https___arxiv_org_abs_2509_16125
institution arXiv
publishDate 2025
record_format arxiv
spellingShingle Who Pays, Who Benefits? Producer-Insurer Games in Life-Saving Medicines
Coculescu, Delia
Janisch, Maximilian
Lehéricy, Thomas
Theoretical Economics
91A80 (Primary), 91B30 (Secondary)
Pharmaceutical markets for life-saving therapies combine monopoly power with insurance coverage. We build a tractable sequential game in which a patent-holder chooses the drug price, a profit-maximising insurer sets its premium, and a population of heterogeneous agents decide whether to insure and, conditional on diagnosis, whether to purchase treatment. Two sufficient statistics - subjective illness probability and reservation price - capture heterogeneity and nest risk-aversion and liquidity-constraint motives within a unified framework. We prove existence of subgame-perfect Nash equilibria and show that entry of an insurer strictly raises producer profits but may raise or lower both drug prices and treatment uptake, depending on the joint distribution of the population statistics. Numerical experiments calibrated to flexible parametric families illustrate non-monotone comparative statics and quantify conditions under which insurance reduces access. Our results provide benchmarks for evaluating price negotiations, price caps, and subsidy schemes in high-cost drug markets.
title Who Pays, Who Benefits? Producer-Insurer Games in Life-Saving Medicines
topic Theoretical Economics
91A80 (Primary), 91B30 (Secondary)
url https://arxiv.org/abs/2509.16125