Evidence map›Paper›PMID 42440808›Full record

ArticleHealth affairs scholar2026

The effect of market size on pharmaceutical innovation: matching estimates to policy questions.

Luca Maini, Mai Anh Tran, Josh Feng

Abstract read
In one paragraph

Article in Health affairs scholar, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
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1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

3 authors.

Luca MainiDepartment of Health Care Policy, Harvard Medical School, Boston, MA 02115, United States.ORCID https://orcid.org/0000-0002-8125-0831
Mai Anh TranHarvard University, Cambridge, MA 02138, United States.ORCID https://orcid.org/0009-0004-1308-7712
Josh FengEccles School of Business, University of Utah, Salt Lake City, UT 84112, United States.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background: The elasticity of pharmaceutical innovation with respect to market size is a key input for evaluating pricing reforms, yet published estimates vary widely. Objective: We examine how much of this variation reflects measurement choices-such as which drugs are counted in innovation outcomes and which countries are included in market size measures-rather than differences in research design. Data and Methods: Using a comprehensive dataset of global pharmaceutical sales, we estimate period-class Poisson regressions following the specification of Dubois et al. (2015), systematically varying the sample of drugs and the measure of market size. Results: Under our preferred specification, estimated elasticities range from 0.21 to 0.30, with estimates as high as 0.47 in other specifications. Restricting to drugs launched in the United States or other large, high-income markets yields significantly higher elasticities than the global sample, but United States and global revenue measures produce similar estimates within each sample, contrary to a common conjecture in the literature. Conclusions: Matching the right elasticity to the right policy question is essential for accurate projections; analysts should select estimates from studies whose measurement choices align with the specific policy and outcomes under evaluation.

Indexed as

drug developmentglobal drug launchesinnovation elasticitymarket sizepharmaceutical innovationR&D incentives

Identifiers

PMID42440808
PMCPMC13334085

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.