International audienceThe rising level of long-term care (LTC) expenditures and their financing sources are likely to impact savings and capital accumulation and henceforth the pattern of growth. This paper studies how the joint interaction of the family, the market and the State influences capital accumulation and welfare in a society in which the assistance the children give to dependent parents is triggered by a family norm. We find that with a family norm in place, the dynamics of capital accumulation differ from those of a standard Diamond (Am Econ Rev 55:1126–1150, 1965) model with dependence. For instance, if the family help is sizeably more productive than other LTC financing sources, pay-as-you-go social insurance might be a complement to private insurance and foster capital accumulation

In this paper we study the e¤ect of reference pricing on pharmaceutical prices and expenditures when generic entry is endogenously determined. We develop a Salop-type model where a brand-name producer competes with generic producers in terms of prices. In the market there are two types of consumers: (i) brand biased consumers who choose between brand-name and generic drugs, and (ii) brand neutral consumers who choose between the di¤erent generic drugs. We …nd that, for a given number of …rms, reference pricing leads to lower prices of all products and higher brand-name market shares compared with a reimbursement scheme based on simple coinsurance. Thus, in a free entry equilibrium, the number of generics is lower under reference pricing than under coinsurance, implying that the net e¤ects of reference pricing on prices and expenditures are ambiguous. Allowing for price cap regulation, we show that the negative e¤ect on generic entry can be reversed, and that reference pricing is more likely to result in cost savings than under free pricing. Our results shed light on the mixed empirical evidence on the e¤ects of reference pricing on generic entry.

International audienceLong-term care (LTC) is mainly provided by the family and subsidiarily by the market and the government. To understand the role of these three institutions, it is important to understand the motives and the working of family solidarity. In this paper, we focus on the case when LTC is provided by children to their dependent parents out of some norm that has been inculcated to them during their childhood by some exemplary behavior of their parents towards their own parents. In the first part, we look at the interaction between the family and the market in providing for LTC. The key parameters are the probability of dependence, the probability of having a norm-abiding child and the loading factor. In the second part, we introduce the government which has a double mission: correct for a prevailing externality and redistribute resources across heterogeneous households

We study the role and the design of long-term care insurance programs when informal care is uncertain; with and without active actuarially-fair private insurance markets against dependency. Three types of public insurance policies are considered: (i) a topping-up scheme, (ii) an opting-out scheme, and (iii) an opting-out-cum-transfer scheme which combines elements of the first two. A topping-up scheme can never do better than private insurance; opting out and opting-out-cum-transfer schemes can because they provide some insurance against the default of informal care. Long-term care policies have different implications for crowding out. A topping-up policy entails crowding out at both intensive and extensive margins and an opting-out policy leads to crowding out solely at the extensive margin. The opting-out feature of an opting-out-cum-transfer policy too leads to crowding out at the extensive margin, but its transfer element leads to crowding out at the intensive margin and crowding in at the extensive margin.

Financial support from the Chaire "Marché des risques et creation de valeur " of the FdR/SCOR is gratefully acknowledged. This paper has been presented at the EHEW 2017 in Oslo, the LAGV conference 2017 in Aix-en-Provence, and in seminars at the Universidad Autònoma de Barcelona and the Frisch Center in Oslo. We thank all the participants and particularly Marcos Vera-Hernández for their comments.