The formation of drug prices in Europe.

Summary Europe's pharmaceutical industry is currently in a complex position. Despite community regulations that have helped bring this market closer to the operating conditions of a single market, medicines continue to circulate in markets with fundamentally different structural characteristics and modes of regulation. In this context, one of the main problems in the completion of the single market for medicines is the level and setting of prices. Based on this observation, we analyze price differentials in the European Union and the diversity of their pricing methods in order to answer two complementary questions: what is the appropriate theoretical framework to explain the differences in drug prices between the different European countries? The first part of the thesis is theoretical and based on the analysis of the discriminating monopoly, as this is the one that has been used in the United States to explain and justify drug price differentials. A critical analysis of the American literature on this subject allows us to show that this theory is not adapted to the explanation of drug price formation in Europe. Hence the need to find a suitable analytical framework, i.e. one that takes into account the institutional characteristics of European markets. We do this in the second part, which is positive and aims to analyze the reality of the interaction of actors in the formation of drug prices in Europe. It is supported by data from the pharmaceutical industry on the impact of regulation on firms' marketing strategies. We finally show that prices in Europe are subject to contradictory forces of diversity and harmonization and that price differentials are narrowing under the action of convergence, which we have qualified as strategic.