NBER Working Papers by Roger Bate

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Working Papers

September 2014Poor Quality Drugs and Global Trade: A Pilot Study
with Ginger Zhe Jin, Aparna Mathur, Amir Attaran: w20469
Experts claim that some Indian drug manufacturers cut corners and make substandard drugs for markets with non-existent, under-developed or emerging regulatory oversight, notably Africa. This paper assesses the quality of 1470 antibiotic and tuberculosis drug samples that claim to be made in India and were sold in Africa, India, and five mid-income non-African countries. We find that 10.9% of those products fail a basic assessment of active pharmaceutical ingredients (API), and the majority of the failures are substandard (7%) as they contain some correct API but the amount of API is under-dosed. The distribution of these substandard products is not random: they are more likely to be found as unregistered products in Africa than in India or non-African countries. Since this finding is robus...
May 2012Counterfeit or Substandard? Assessing Price and Non-Price Signals of Drug Quality
with Ginger Zhe Jin, Aparna Mathur: w18073
Pharmaceutical products can be of poor quality either because they contain zero correct active ingredient (referred to as "counterfeit") or because they contain a non-zero but incorrect amount of the right active ingredient (referred to as "substandard"). While both types of poor-quality drugs can be dangerous, they differ in health consequence, price, and potential policy remedies. Assessing basic quality of 1437 samples of Ciprofloxacin from 18 low-to-middle-income countries, we aim to understand how price and non-price signals can help distinguish counterfeits, substandard drugs, and passing drugs. Following the Global Pharma Health Fund e.V. Minilab® protocol, we find 9.88% of samples have less than 80% of the correct active ingredient and 41.5% of these failures are counterfeits. B...

Roger Bate, Ginger Zhe Jin and Aparna Mathur “Falsified or Substandard? Assessing Price and Non-Price Signals of Drug Quality” forthcoming the Journal of Economics & Management Strategy, Volume 24, Issue 4, pages 687–711, Winter 2015

March 2012In Whom We Trust: The Role of Certification Agencies in Online Drug Markets
with Ginger Zhe Jin, Aparna Mathur: w17955
This paper uses an audit sample and a consumer survey to study the intriguing market of online prescription drugs facing US customers, and assesses the role that certification agencies play in online drug markets. On the supply side, we acquire samples of five popular brand-name prescription drugs from three types of online pharmacies: tier 1 are US-based and certified by the National Association of Boards of Pharmacy (NABP) or, tier 2 are certified by or the Canadian International Pharmacy Association (CIPA) but not by NABP or LegitScript, tier 3 are not certified by any of the four agencies. Most tier 2 and tier 3 websites are foreign. We find that 37 of the 365 delivered samples are different from the products we ordered and therefore non-testable. C...

Published: Roger Bate, Ginger Zhe Jin and Aparna Mathur# “In Whom We Trust: the Role of Certification Agencies in Online Drug Markets,” the Berkeley Express Journal of Economic Analysis & Policy, Contribution Tier, Volume 14, Issue 1, Pages 111–150, ISSN (Online) 1935-1682, ISSN (Print) 2194-6108, DOI: 10.1515/bejeap-2013-0085, December 2013. Also available as NBER working paper #17955.

March 2011Does Price Reveal Poor-Quality Drugs? Evidence from 17 Countries
with Ginger Zhe Jin, Aparna Mathur: w16854
Focusing on 8 drug types on the WHO-approved medicine list, we constructed an original dataset of 899 drug samples from 17 low- and median-income countries and tested them for visual appearance, disintegration, and analyzed their ingredients by chromatography and spectrometry. Fifteen percent of the samples fail at least one test and can be considered substandard. After controlling for local factors, we find that failing drugs are priced 13.6-18.7% lower than non-failing drugs but the signaling effect of price is far from complete, especially for non-innovator brands. The look of the pharmacy, as assessed by our covert shoppers, is weakly correlated with the results of quality tests. These findings suggest that consumers are likely to suspect low quality from market price, non-innovator br...

Published: Published in the Journal of Health Economics 30 (2011) 1150-1163 citation courtesy of

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