title: Creative compliance in pharmaceutical markets: the case of profit controls.
abstract: This article discusses the issue of creative compliance in pharmaceutical markets. In particular, we explore the case of profit controls in the UK as an indirect way of regulating prices of in-patent originators. We study creative compliance in the presence of profit controls, rather than price controls or the Pharmaceutical Price Regulation Scheme in general. We use lessons from the accounting literature to explain firm behavior and reveal potential weaknesses in profit control regulation and use data to show changes in trends following the introduction of this policy. We demonstrate that in the presence of profit controls there is an incentive for producers to increase costs (leading to inefficiencies) or to inflate reported costs. We find some evidence that the behavior of pharmaceutical firms in the UK may have changed as a result of the introduction of profit controls. Although the evidence is in line with what we would expect to occur as a result of creative compliance, establishing a concrete causal relationship between such a pricing policy and costs is not possible. As institutions or organizations look to achieve legitimacy for their actions, they will use the tools they have, whether accounting or regulatory, to best represent themselves.
authors.affiliation: LSE Health, Cowdray House, London School of Economics, Houghton Street, London WC2A 2AE, UK.
authors.forename: James
authors.initials: J
authors.lastname: Bradley
authors.forename: Sotiris
authors.initials: S
authors.lastname: Vandoros
mesh_terms: D016527:Drug Costs; D004345:Drug Industry / Q000191:economics* / Q000331:legislation & jurisprudence; D017850:Economics, Pharmaceutical; D017598:Efficiency, Organizational; D019983:Guideline Adherence; D006801:Humans; D004364:Pharmaceutical Preparations / Q000191:economics; D006113:United Kingdom
chemical_list: D004364:Pharmaceutical Preparations