Health Care

In February, the Federal Trade Commission settled with pharmaceutical benefits manager (PBM) Express Scripts. The FTC had sued Express Scripts and two other large PBMs under the long dormant Section 5 of the FTC Act, which targets “unfair methods of competition.” The settlement suggests that the FTC may succeed in addressing the convoluted contracts between PBMs, drug manufacturers, health insurers, and employers that drive up drug prices for Americans. It also opens unchartered territory for antitrust enforcement and the limits of Section 5, argue Fiona Scott Morton and Mariah Smith.

In new research, Renuka Diwan, Paul Eliason, Riley League, Ryan C. McDevitt, James W. Roberts, and Jetson Leder-Luis investigate how Medicare’s shift to a competitive bidding system to reduce prices has inadvertently shifted market share to fraudulent suppliers.

Antitrust authorities increasingly assess mergers through the lens of innovation, particularly in research-intensive sectors such as pharmaceuticals. In new research, Carmine Ornaghi and Lorenzo Cassi show how mergers disrupt human capital and reduce innovation in what they call manslaughter acquisitions.

In new research, Martin Schmalz and Jin Xie examine how shareholder preferences influence the United States pharmaceutical industry. They find that generic-drug manufacturers sometimes harm their firms’ own value when doing so benefits shareholder portfolios, who frequently have stakes in competing brand-name firms.

Hannah Pittock uses weight-loss company Novo Nordisk’s offer to acquire Metsera to create a three-prong framework by which the antitrust agencies can identify when an invitation to exclude a rival from a market constitutes illegal exclusionary conduct under Section 2 of the Sherman Act.

Steve Salop explores the anticompetitive innovation behind weight-loss giant Novo Nordisk’s offer to acquire Metsera. Novo’s proposed contract presents a new tactic by which firms with market power can preclude rival mergers that will lead to procompetitive entry.

President Donald Trump has, across two administrations, sought to lower drug prices for Americans, most recently with executive order “Delivering Most-Favored-Nation Prescription Drug Pricing to American Patients.” Margherita Colangelo explains why his order is unlikely to accomplish its goal.

In new research, Benjamin Wood, Sven Gallasch, Nicholas Shaxson, Katherine Sievert, and Gary Sacks write that competition underenforcement and a narrow regulatory focus on prices and output has allowed industries that produce harmful consumer products, such as tobacco or ultra-processed foods, to increase demand and, consequentially, harm to society. They argue that competition law must evolve to consider health impacts.

Anthony T. LoSasso, Ge Bai, and Lawton Robert Burns argue that critics of private equity’s involvement in healthcare ignore that it is often the only financial lifeline available to distressed healthcare providers and can introduce an improvement in outcomes, including quality of care.

Theodosia Stavroulaki reviews how the involvement of private equity in American healthcare leads to, among other negative outcomes, burnout and stress among healthcare workers, particularly physicians. She writes that the consequences could cripple America’s healthcare system.