The Drug Price Control Order 2013 (DPCO) in India, regulated the prices of certain essential and life-saving drugs to ensure their affordability and availability; with the expectation that this would translate into boosting the sales of those drugs. To assess whether such a sales increase was achieved, we study the effects of the regulation on sales volumes of each regulated drug using a synthetic control approach with sales data from a comparable country which did not experience a regulatory change. We assess the robustness of our results via multiple empirical approaches to triangulate our findings. Contrary to the order’s objectives, we find that sales volumes decline for regulated drugs. Since the order placed restrictions on production levels and on drugs exiting the market, the lowered margins of regulated drugs could have pushed pharmaceutical firms to reduce their marketing expenditures on them. We provide evidence of such a reduction using detailing data from a large pharmaceutical firm. We illustrate that this shift in detailing adversely affected prescriptions from physicians without formal medical degrees who treat the poor and disadvantaged in India; patients that the DPCO was intended to help the most. A survey we conducted shows that these physicians rely on detailing more than medically trained doctors. Taken together, our results provide insights into the strategic actions of firms when faced with regulations, and highlights their unintended consequences. The generalizable nature of our study’s findings across a broad set of medications, has implications for governmental agencies in terms of the need to account for the entire ecosystem of patients, physicians, pharmaceutical firms and pharmacies when implementing such regulations.

中文翻译：

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表达：没有伤害吗？印度药品价格监管的意外后果

印度的 2013 年药品价格控制令 (DPCO) 规范了某些基本药物和救生药物的价格，以确保其可负担性和可用性；预计这将转化为促进这些药物的销售。为了评估是否实现了这样的销售增长，我们使用综合控制方法，利用未经历监管变化的可比国家的销售数据，研究了监管对每种监管药物销量的影响。我们通过多种实证方法对我们的发现进行三角测量来评估我们结果的稳健性。与该命令的目标相反，我们发现受管制药物的销量下降。由于该命令对生产水平和退出市场的药品施加了限制，受监管药品利润率的降低可能会促使制药公司减少其营销支出。我们使用一家大型制药公司的详细数据提供了这种减少的证据。我们举例说明，这种详细描述的转变对治疗印度穷人和弱势群体的没有正式医学学位的医生的处方产生了不利影响；DPCO 旨在帮助最多的患者。我们进行的一项调查显示，这些医生比受过医学训练的医生更依赖细节。总而言之，我们的研究结果提供了对企业在面临监管时的战略行动的见解，并强调了其意想不到的后果。我们的研究结果在广泛的药物中具有普遍性，这对政府机构具有影响，因为在实施此类法规时需要考虑患者、医生、制药公司和药房的整个生态系统。