Perverse Reverse Price Competition: Average Wholesale Prices and Medicaid Pharmaceutical Spending
          
                  Abby Alpert, Mark Duggan , and Judith K. Hellerstein
      
  
, 
(    
                  108
      
  
)
            Journal of Public Economics
      
            44-62
      
            December
      
            2013
          
                          
      
  
  Abstract
              Generic drugs comprise an increasing share of total prescriptions dispensed in the U.S., rising from nearly 50% in 1999 to 75% in 2009. The generic drug market has typically been viewed at the wholesale level as a competitive market with price approaching marginal costs. However, the large presence of third party payers as final purchasers may distort prices at the retail level relative to what a standard model of price competition would predict. In this paper, we investigate how generic drug producers compete in the presence of the procurement rules of the Medicaid program.
