       Document 0293
 DOCN  M9550293
 TI    Firm behavior in the U.S. market for factor VIII: a need for policy?
 DT    9505
 AU    Nauenberg E; Sullivan SD; Department of Social and Administrative Health
       Sciences,; University of California, Berkeley 94720.
 SO    Soc Sci Med. 1994 Dec;39(12):1591-603. Unique Identifier : AIDSLINE
       MED/95149158
 AB    In this paper, we historically examine the market for Factor VIII
       concentrate, a collection of blood products used in the treatment of
       hemophilia A. With the introduction of HIV-1 into the U.S. blood supply,
       a majority of American hemophiliacs became infected with the virus. In
       response to contamination, the pharmaceutical manufacturers producing
       Factor VIII concentrate developed highly purified products which were
       introduced in the late 1980s at four to five times the price of the
       older, intermediate purity products. These new products are highly
       valuable in protecting the 30% of hemophiliacs who are HIV-1
       seronegative; however, for those individuals previously infected by the
       virus, the extra benefit of the more costly products was questionable at
       the time they were first introduced. We postulate that there has been
       some level of industry coordination among the producers of Factor VIII
       concentrates to supply only the more expensive, highly purified products
       even though there appeared to be significant demand for the intermediate
       purity products by HIV-1 infected hemophiliacs. We develop and present a
       model that is useful for testing an inter-product collusion hypothesis.
       Further, we hypothetically discuss the model's implications and develop
       some public health policy options that might improve the competitive
       performance of the market.
 DE    Cost Control  Drug Industry/*ECONOMICS/HISTORY  Factor
       VIII/*ECONOMICS/HISTORY/THERAPEUTIC USE  *Fees,
       Pharmaceutical/HISTORY/TRENDS  Health Policy/HISTORY/LEGISLATION &
       JURISPRUD  Hemophilia/HISTORY/*THERAPY  History of Medicine, 20th Cent.
       Human  HIV Infections/HISTORY/TRANSMISSION  *HIV-1  Interinstitutional
       Relations  Risk Factors  United States  HISTORICAL ARTICLE  JOURNAL
       ARTICLE

       SOURCE: National Library of Medicine.  NOTICE: This material may be
       protected by Copyright Law (Title 17, U.S.Code).

