AAI Healthcare Roundtable: Competition and Healthcare – Enforcement and Policy Priorities

YEAR IN REVIEW
These opening remarks will set the table for the day’s discussion. The Year in Review will identify recent major antitrust, regulatory, legislative, and policy developments that affect the competition landscape. Unpacking the complex and varied enforcement roles of the U.S. Department of Justice, Federal Trade Commission, and state antitrust enforcers will be an important segue to discussion later in the day. Themes and trends identified in the Year in Review will also provide connection points to panel discussions on mergers, pricing, innovation, and the capstone roundtable.

PANEL 1: MERGERS OF HEALTHCARE PROVIDERS – MARKET DEFINITION, COMPETITIVE EFFECTS, AND EFFICIENCIES
This panel will look at the motivation for and effects of consolidation in provider markets such as hospitals and physician practices. As consolidation has progressed, attention to legal-economic approaches underlying merger analysis has intensified. Panelists will identify emerging trends in provider merger enforcement, including defining relevant markets; analyzing competitive effects, including cross-market effects, evaluating efficiencies claims, and assessing the effectiveness of antitrust remedies. Panelists will put into context the accumulating evidence on the effects of previous hospital mergers and lend some order to the various enforcement outcomes in key merger cases.

PANEL 2: COMPETITION IN PHARMACEUTICAL MARKETS – UNPACKING COMPETITION, INTELLECTUAL PROPERTY, AND MARKET ENTRY
This panel will examine the competitive and consumer issues raised by the controversial nexus between competition and intellectual property law. This intersection has important implications for market entry, innovation, and competitive outcomes and is particularly timely given recent, high profile concerns over drug pricing. Panelists will analyze the state of law and economics relating to “pay for delay” and “product hopping” involving incumbent branded and generic pharmaceutical entrants. The panel will unpack the nature of these agreements and practices. They will consider competition issues as they have arisen in public and private antitrust cases, and consider ways in which public and private enforcement can serve as complementary tools for promoting competition and consumer benefits.

PANEL 3: HEALTH INSURANCE MARKETS – MERGERS, AGREEMENTS, AND THE CHANGING COMPETITIVE LANDSCAPE
This panel will discuss key competitive issues in health insurance markets, including the two major health insurance mergers. As health insurance markets have consolidated, myriad issues have come to the fore, including market definition, the nature of competition, claimed efficiencies, bargaining power, and the effectiveness of past remedies. Panelists will discuss these issues, as well as whether lower provider payments reflect monopsony power or bargaining efficiencies, and whether lower costs would be passed on consumers. The panel will also consider potentially anticompetitive agreements in which health insurance features prominently in efforts to limit entry or allocate markets.