The Human Cost of Collusion: Health Effects of a Mexican Insulin Cartel

• 成果类型: Article
• 署名作者: Barkley, Aaron
• 署名单位: University of Melbourne
• 刊物名称: JOURNAL OF THE EUROPEAN ECONOMIC ASSOCIATION
• ISSN/ISSBN: 1542-4766
• DOI: 10.1093/jeea/jvad005
• 发表日期: 2023
• 页码: 1865-1904
• 关键词: medicare-part-d; developing-countries; hospital mergers; market power; low-income; COMPETITION; pharmaceuticals; mortality; inference; QUALITY

摘要

Despite recent attention to the role of competition in determining health outcomes in developed nations, little is known about how market power impedes access to quality care in lower-income countries. This paper studies the effects of policy changes that stopped collusion among firms supplying insulin to one of Mexico's largest health care providers. I document increased insulin utilization and decreased diabetes complications and mortality following the sudden drop in insulin prices caused by the cartel's collapse. These adverse health outcomes expand the assessment of damages caused by the cartel. The findings highlight the importance of market design policies in health markets, particularly for low- and middle-income countries.