Research

Incentivizing Novelty in Antibiotic Development

In antibiotics, a constant supply of new products is needed as bacteria become resistant to the existing drugs. I estimate the effectiveness of innovation incentives for antibiotics, introduced in 2012. In a difference-in-differences framework, I find that the incentives have a positive effect on clinical trial success rates, but only for projects using known technologies. To assess the long-term effect of the incentives on market entry, I set up a dynamic structural model of pharmaceutical innovation. The multi agent setting of the model allows the firm decisions to depend not only on the projects’ expected cost and profit, but also on the outcomes of technologically close projects. Counterfactual simulations show a 20% increase in the number of market entries due the current incentive scheme, driven mostly by research subsidies.

Presentations: Workshop on the Economics of Antibiotics, Toulouse; INAMRSS/CeBIL AMR Workshop, Copenhagen; Aalto University, Helsinki; University of Copenhagen; McGill University, Montreal; ZEW Mannheim; ESSEC Business School, Paris; University of Geneva; IIOC, DC; 1st CEPR Conference in Health Economics, Toulouse; EARIE, Rome; Immunotherapies & Innovation for Infectious Diseases, Lyon; North American Winter Meeting of the Econometric Society, San Antonio; HEC/INSEAD/ESSEC Annual Seminar, Paris; Workshop on the economics of startup acquisitions, Bern; BSE Summer Forum Workshop Economics of Science and Innovation; EEA 2024 Rotterdam; THEMA Theoretical and Applied Economics Seminar, Paris;

Mergers and Advertising in the Pharmaceutical Industry (with Pierre Dubois)

In many industries, market structure determines how firms not only compete in terms of prices but also utilize promotional activities. We study how price and advertising strategies change when firms merge in pharmaceutical markets in the US. We show that across all drug markets, although mergers indeed increase prices, advertising spending also decreases. Merger simulations not accounting for advertising reductions may thus obtain biased price effects. Considering the merger effects of two large pharmaceutical companies on an antimicrobial drug market, we estimate a structural model of supply and demand and simulate the merger effect. We find that the merger effect on prices is smaller given the reduction in the amount of advertising. We also provide a simple method through which to evaluate long-term welfare effects using some known value of the sensitivity of innovation to profits.

Presentations: MaCCI Annual Conference, Mannheim; ENTER Seminar, Stockholm School of Economics; EEA, Milan; EARIE, Vienna;

Drug Shortages: Empirical Evidence from France (with Pierre Dubois and Valentina Reig)

Drug shortages are a problem widely documented around the world. We develop a simple method allowing to identify shortage events and their intensity using sales data at a national level. In the case of prescription drugs, shortages occur when the quantities supplied do not meet demand at regulated prices. Using sales data only, shortages that are driven by supply shocks affect only the lower distribution of sales quantities and can be identified using a demand prediction model estimated on sales observed above a given quantile threshold. We can then measure the likelihood and the magnitude of shortage events. We provide evidence that lower French prices increase the likelihood and magnitude of shortages in France. However, higher prices in the UK seem to have positive spillover effects on reducing the likelihood of shortages, while a negative one when shortages happen and there is competition for scarce resources internationally. Finally, we provide evidence on the heterogeneous effects of shortage reductions achievable through higher regulated prices in France.

Presentations: European Workshop on Econometrics and Health Economics, Madrid; ESSEC internal seminar, Paris; EARIE, Amsterdam; Paris IO Day; The Finnish Health Economics Seminar Series;

Universal Subsidies in Pharmaceutical Markets: Lessons from Poland’s Drugs 75+ Policy (with Krzysztof Zaremba)

Widely used public policies fully subsidizing essential goods and services aim to improve access, but removing price signals may also produce distortions. We investigate this problem by leveraging Poland’s Drugs 75+ program, which provides free prescription medications to individuals aged 75 and older, as a natural experiment. Using a difference-in-discontinuities approach, event studies, and detailed administrative and survey data, we draw three main conclusions. First, the program reduced out-of-pocket medication expenditures for seniors, substantially alleviating the risk of catastrophic health costs. Second, it improved access: medication consumption increased, particularly for higher-cost products, to some extent displacing cheaper alternatives. Third, the shift in consumption patterns increased public payer costs per dose of treatment. These findings highlight the challenges of subsidy programs that eliminate price signals, as they can alter demand in ways that improve access but undermine cost-effectiveness.

Presentations: ESSEC Internal Seminar; EuHEA Online Seminar; American-European Health Economics Study Group, Oxford; 11th IRDES-LIRAES Workshop on Applied Health Economics and Policy Evaluation, Paris; 3rd Health Economics Conference, Toulouse;

The Financial and Behavioral Effects of Free Prescription Drugs: Evidence from a Policy Discontinuity in Poland (with Krzysztof Zaremba) R&R at Health Economics

We examine whether a universal drug subsidy for seniors in Poland provided effective financial protection and whether it induced ex ante moral hazard. The policy eliminated out-of-pocket costs for prescription medications while leaving all other healthcare coverage unchanged. Using detailed household expenditure data and a sharp age-based eligibility threshold, we implement a difference-in-discontinuities design to estimate causal effects. The reform reduced average medication spending and lowered the incidence of catastrophic drug expenditures by 62%, with gains concentrated in the upper tail of the spending distribution—consistent with insurance against large health shocks. Eligibility also led to higher spending on alcohol and cigarettes, indicative of reduced precautionary behavior, potentially consistent with ex ante moral hazard. These results highlight that while public subsidies can meaningfully reduce financial risk, they may also induce behavioral responses that partially offset intended health benefits.

Work in Progress:

Mergers and Innovation in the Pharmaceutical Industry (with Pierre Dubois)