Using drug prices from the Veteran Affairs office, we document limited clustering on whole dollars and heightened strategic pricing. Surprisingly 97.9% of drugs over $10,000 are priced down to the cents. We find no significant variations in clustering by price levels or uncertainty, rejecting the negotiation hypothesis. Strategic pricing on 01 and 99 increases monotonically as prices decline. For international drug prices, we find significant clustering on integers in Luxembourg and South Africa as price level increases, supporting the negotiation hypothesis. Our findings contribute to better negotiating drug prices to reduce healthcare costs while not discouraging innovations in drug development.

使用退伍军人事务办公室的药品价格，我们记录了整个美元的有限集群和更高的战略定价。令人惊讶的是，超过 10,000 美元的药物中有 97.9% 的价格低至美分。我们发现价格水平或不确定性的聚类没有显着变化，拒绝谈判假设。01 和 99 的战略定价随着价格的下降而单调增加。对于国际药品价格，我们发现随着价格水平的上升，卢森堡和南非的整数显着聚集，支持了谈判假设。我们的研究结果有助于更好地谈判药品价格以降低医疗保健成本，同时不会阻碍药物开发的创新。