Léa Bignon will defend her thesis on Thursday 10th July 2025 at 04:00 PM (Auditorium 6, TSE Building and online)
Title: Essays in Industrial Organization and Health Economic
Supervisor: Professor Pierre DUBOIS
To attend the conference, please contact the secretariat of the TSE Doctoral school.
Memberships are:
- Pierre Dubois: Professor of Economics, University of Toulouse Capitole Supervisor
- Bruno Jullien: Senior Researcher, CNRS/TSE-R Examinateur
- Ashley Swanson: Associate Professor of Economics, University of Wisconsin-Madison Rapporteure
- Amanda Starc: Associate Professor of Economics, Kellogg School of Management, NU Rapporteure
Abstract :
This thesis studies Industrial Organization questions arising in pharmaceutical markets where (i) new technologies increase individual-level information available for decision making; (ii) private insurers' incentives can undermine consumer protection; and (iii) the cost structure of new treatments challenges traditional pricing rules.
In the first chapter, entitled “Pharmaceuticals and Digital Health: How Data-driven Insights May Reshape the Insulin Market”, I document cross-market complementarities between medical devices and pharmaceuticals -- how innovative medical devices, generating individual-level health data, can shape demand, pricing, and innovation incentives in pharmaceutical markets. I study these questions by analyzing the impact of Continuous Glucose Monitors (CGMs) on the insulin market, where the high-frequency data from CGMs can reduce the information frictions that physicians face about drugs. Using French health insurance claims data, I show that CGMs shift drug choices through new observable attributes (e.g. overnight performance). The device allows the manufacturers of drugs with strong performance on newly observable attributes to benefit from higher demand and set higher prices. My findings indicate that the introduction of these new attributes into pharmaceutical demand can alter the relative profitability of drug innovation strategies, thereby shaping future pharmaceutical innovation.
In the second chapter, entitled “Strategic Tier Design in Health Insurance: The Case of Medicare Part D" and co-authored with Laura Lasio and Alessandro Iaria, we study how Medicare Part D insurers strategically manipulate drug tiers to increase generic drugs’ cost sharing. We show that plans increasingly moved generics to higher tiers, raising out-of-pocket costs despite regulatory constraints. Exploiting institutional rules and regional variation, we estimate that this “tier upgrading” raised generic spending by up to $100 per enrollee and reduced utilization. We find that welfare losses include reduced adherence to high-value drugs.
In the third chapter, entitled “Biologic Drugs and Learning-by-Doing” and co-authored with Pierre Dubois, we measure the extent of learning-by-doing in the production process of biologic drugs, which are complex therapies. Using international drug sales data, we estimate a model of demand, pricing, and production for biologic drugs. We find that the marginal costs of biosimilars decreased by 46% since market entry, partly due to returns to experience. As biologic drugs production is geographically concentrated, learning-by-doing creates inter-temporal and international spillovers in cost efficiencies. Delayed biosimilar entry in one country raises costs in others. These dynamics challenge static drug pricing rules.
