PhD Studentship (ESRC South Coast DTP) - The effects of generic entry on prescription patterns and

Location: Highfield Campus

Salary:  £14553

Annual stipend of £14553 plus payment of programme fees.

Closing Date:  Wednesday 28th June 2017

Reference: 878017CC

The effects of generic entry on prescription patterns and their effects on patients’ outcome

A fully funded studentship awarded by the Economic and Social Research Council (ESRC) South Coast Doctoral Training Partnership (SCDTP)

Supervisory Team:

Assoc Prof Carmine Ornaghi – Economics Department (C.Ornaghi@soton.ac.uk), Assoc Prof Emmanouil Mentzakis – Economics Department, Professor Paul Roderick - Faculty of Medicine, Dr Simon Fraser – Faculty of Medicine

There is a growing literature in economics that looks at the effects of generics entry on both the molecule that loses patent protection and competing molecules still on-patent. The aim of the research is to investigate whether the introduction of generic molecules following patent expiration leads to substantial changes in the prescription decisions of GPs and whether these changes in prescription habits have sizable effects on patients’ health outcome. The analysis will be based on the Hampshire Prescription Record, which provides detailed information on the prescription decisions of GP practises and CCGs in Hampshire over the last two decades. 

Skills required of the PhD student:

• Understanding of the pharmaceutical sector, patent-based drug development, drug prescription strategies in single-payer systems

• Ability to search, review, critically evaluate, summarize and synthesize academic literature

• Ability to perform statistical and regression analysis, empirically identify causality and relevant methodologies, interpret finding and draw inference

• Ability to communicate clearly and convey specialized information to experienced and lay individuals alike

The aim of the research is to investigate whether the introduction of generic molecules following patent expiration leads to substantial changes in the prescription decisions of GPS and whether these changes in prescription habits have sizable effects on patients’ health outcome. The analysis will be based on the Hampshire Prescription Record, which provides detailed information on the prescription decisions of doctors in Hampshire over the last two decades  

Generics entry can dramatically change prescription patterns because of two different reasons. First, bioequivalent competitors are typically sold at a fraction of the price of their branded version and doctors may decide (or may be encouraged by their CCG) to use them as a measure to contain the increasing cost of health care. But generics entry also leads to a significant reduction in the level of promotion of a molecule even before patent expiration, because the pharmaceutical company owner of the patent anticipates that their market will be taken over by generic producers. This drops in advertising acts to counterbalance the price effect as doctors are no longer “persuaded” to prescribe that drug.

Given that price and promotion works in opposite direction, the question of how generic drugs affect prescription decisions can only be solved empirically. Therefore, the first aim of this research is then to document changes in prescription patterns following generics entry for different GP practises and CCGs in Hampshire. Building upon the results of the first part of the research, the second question will examine whether the observed changes in prescription decisions affect patients’ health outcome. The article by Cao et al (2015) on anti-cholesterol drugs offers an interesting example on how prescription patterns can be related to health outcomes.

Compared to the existing literature, the proposed research presents three main novelties. First, most of existing studies in economics use aggregate data, typically total sales of competing molecules in a therapeutic area (see the literature review in Castanheira et al., 2017). Using patients’ information from the Hampshire Health Record allows us to understand whether “aggregate” changes in prescription patterns are driven by market expansion effects (i.e. more patients are prescribed a molecule) or market stealing effects (i.e. the same patient is now prescribed a different drug). Second, the vast majority of this research has focused on the US market. Our analysis will provide valuable evidence on whether generics can be used more effectively to fight ballooning drug prices for the UK. Finally, to the best of our knowledge, this is the first study that will try to assess the impact of generics entry not only as cost containment strategy but also their impact on patient outcomes.

Funding

South Coast DTP Funding provides an annual maintenance grant (tax free) of £14553, plus payment of all programme fees.  Other funding available for SCDTP funded students can be found on the SCDTP website (southcoastdtp.ac.uk).

Funding is provided for 3 years full-time PhD study (pro-rata for part-time students).  Applications for 1+3 funding for students completing a Master's year prior to the commencement of PhD study are also welcome (details available at southcoastdtp.ac.uk).

Application Procedure

The closing date and time for applications is noon on 28th June 2017.  The full application procedure, the funding application form, and more information on the South Coast Doctoral Training Partnership can be found at:

http://southcoastdtp.ac.uk/how-to-apply/

For further information about this project, please contact the lead supervisor detailsed above.  For questions relating to the application procedure, or for more information about the SCDTP, please visit the SCDTP website or contact us at scdtp@soton.ac.uk