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on Health Economics |
| By: | Sidhya Balakrishnan; Roberta Costa; Johannes Haushofer; Fábio Waltenberg |
| Abstract: | We investigate the impact of a permanent unconditional cash transfer called “Citizen’s Basic Income” in the city of Maricá, Brazil. At the time of the study, the program made monthly household-level transfers of USD 180 PPP on average to about a fourth of the city’s residents. The program is unique in that it is both unconditional and permanent, while existing programs typically only have one of these features. Between September 2021 and April 2022, we surveyed 5, 182 individuals, about half of whom received the RBC. We use propensity score matching with inverse probability weights to create a matched comparison group and estimate the effect of the program on economic, social, and psychological outcomes. Our results reveal several positive welfare effects. Household income including transfers increased by 9%; consumption at the per capita level did not change significantly, but the household as a whole experienced a consumption increase of 5%. We also observe improvements in an index of children’s health and education, although the effect does not survive multiple inference correction and bounding. There was a notable displacement of other income sources, particularly labor income, which decreased by 17% among recipients, suggesting shifts to lower-paying but potentially more desirable jobs during the pandemic. The program also led to increased access to financial services, but decreased the propensity to save. These findings paint a nuanced picture of the socioeconomic benefits of unconditional cash transfers and established cash transfer administrative systems. |
| JEL: | H3 O12 O23 |
| Date: | 2024–10 |
| URL: | https://d.repec.org/n?u=RePEc:nbr:nberwo:33089 |
| By: | Ashvin Gandhi; Ian Larkin; Brian McGarry; Katherine Wen; Huizi Yu; Sarah Berry; Vincent Mor; Maggie Syme; Elizabeth White |
| Abstract: | Health care facilities considering mandating staff vaccination face a difficult tradeoff. While additional vaccination coverage will directly reduce disease transmission within the facility, the imposition of a mandate may also cause vaccine-hesitant staff to quit, which could harm patient care. To study this tradeoff, we leverage comprehensive administrative data covering virtually all US nursing homes, including payroll-based records on approximately 500 million daily nurse shifts and weekly data on COVID transmission and mortality at each facility. We use a difference-in-differences framework to estimate the impact of employer-imposed vaccine mandates at 581 nursing homes on disease spread, employment outcomes, and several patient care metrics. While mandates did slightly increase staff turnover, the effects were concentrated on staff working less than 20 hours per week, and resulted in a reduction of less than two minutes per patient-day. Furthermore, there is only limited evidence of lower levels of care at mandate facilities in typically-monitored conditions such as patient falls, pressure ulcers, or urinary tract infections. In contrast, implementing a vaccine mandate led to large increases in staff vaccinations at mandate facilities, which directly led to less transmission of and lower patient mortality from COVID. We estimate that vaccine mandates saved one patient life for every two facilities that enacted a mandate, a large effect given the typical facility has around 100 beds. Our results suggest that the health benefits of mandates far outweigh the costs in terms of reduced patient care from staff turnover. |
| JEL: | I1 I10 I12 I18 J2 J28 J30 |
| Date: | 2024–10 |
| URL: | https://d.repec.org/n?u=RePEc:nbr:nberwo:33072 |
| By: | Breitkopf, Laura (Max Planck Institute for Research on Collective Goods); Chowdhury, Shyamal (University of Sydney); Priyam, Shambhavi (Max Planck Institute for Research on Collective Goods); Schildberg-Hörisch, Hannah (Max Planck Institute for Research on Collective Goods); Sutter, Matthias (Max Planck Institute for Research on Collective Goods) |
| Abstract: | We study the relationship between parenting style and a broad range of children's skills and outcomes. Based on survey and experimental data from 5, 580 children and their parents, we find that children exposed to positive parenting have higher IQs, are more altruistic, open to new experiences, conscientious, and agreeable, have a higher locus of control, self-control, and self-esteem, perform better in scholarly achievement tests, behave more prosocially in everyday life, and are more satisfied with their life. Positive parenting is negatively associated with children's neuroticism, patience, engagement in risky behaviors, and their emotional and behavioral problems. |
| Keywords: | parenting style, child outcomes, economic preferences, personality traits, IQ |
| JEL: | C91 D01 D10 |
| Date: | 2024–09 |
| URL: | https://d.repec.org/n?u=RePEc:iza:izadps:dp17336 |
| By: | Britto, Diogo (University of Milan Bicocca); Daniele, Gianmarco (Bocconi University); Le Moglie, Marco (Bocconi University); Pinotti, Paolo (Bocconi University); Sampaio, Breno (Universidade Federal de Pernambuco) |
| Abstract: | We study the prevalence and effects of individuals with past criminal charges among candidates and elected politicians in Brazil. Individuals with past criminal charges are twice as likely to both run for office and be elected compared to other individuals. This pattern persists across political parties and government levels, even when controlling for a broad set of observable characteristics. Randomized anti-corruption audits reduce the share of mayors with criminal records, but only when conducted in election years. Using a regression discontinuity design focusing on close elections, we demonstrate that the election of mayors with criminal backgrounds leads to higher rates of underweight births and infant mortality. Additionally, there is an increase in political patronage, particularly in the health sector, which is consistent with the negative impacts on local public health outcomes. |
| Keywords: | politicians, crime, audits, policies, patronage |
| JEL: | K42 J45 P16 |
| Date: | 2024–09 |
| URL: | https://d.repec.org/n?u=RePEc:iza:izadps:dp17328 |
| By: | Nicole Black (Centre for Health Economics, Monash Business School, Monash University); Anthony Harris (Centre for Health Economics, Monash Business School, Monash University); David W. Johnston (Centre for Health Economics, Monash Business School, Monash University); Trong-Anh Trinh (Centre for Health Economics, Monash Business School, Monash University) |
| Abstract: | To improve access to affordable mental healthcare, Australia introduced a national, publicly-funded program in 2006 to subsidise psychological services, which were previously privately funded. Theory suggests that by increasing demand, subsidies should incentivise providers to expand supply, either by entering the workforce or by increasing hours. However, expansion depends on supply constraints, particularly in non-metropolitan areas with pronounced workforce shortages. This study examines the program’s effects on the size, work hours, demographic composition, earnings, and location of practising psychologists. Using a difference-in-differences approach with census data and Australian Tax Office records, we find that the program: (1) increased the supply of practising psychologists by 47% within five years, with minimal effect on average hours worked per psychologist; (2) raised psychologists’ annual personal incomes by 17%; and (3) increased the likelihood of psychologists working in non-metropolitan areas by 8%, supporting broader access to mental healthcare. |
| Keywords: | Psychologist, Mental Healthcare, Better Access Initiative, Health Workforce |
| JEL: | I10 I18 |
| Date: | 2024–10 |
| URL: | https://d.repec.org/n?u=RePEc:mhe:chemon:2024-17 |
| By: | Costi, Chiara (University of Luxembourg); Clark, Andrew E. (Paris School of Economics); D'Ambrosio, Conchita (University of Luxembourg); Lepinteur, Anthony (University of Luxembourg); Menta, Giorgia (LISER) |
| Abstract: | We here exploit an exogenous shift in working conditions for public-sector workers in Italy to establish the causal effect of a return-to-office (RTO) mandate on worker health and well-being. In nine waves of quarterly panel data we first find a significant fall in teleworking for those affected by the RTO mandate, who also spend more time outdoors, work fewer hours, and interact less with relatives and friends. The net effect of these lifestyle changes on a battery of health and well-being measures following the return to office work is insignificant. The place of work post-pandemic has neither positive nor negative health implications. |
| Keywords: | return to office, working from home, health, well-being |
| JEL: | I18 I31 J88 |
| Date: | 2024–10 |
| URL: | https://d.repec.org/n?u=RePEc:iza:izadps:dp17355 |
| By: | Katharine G. Abraham; Henry S. Farber |
| Abstract: | Prior to the passage of the Affordable Care Act (ACA), part-time workers were much less likely than full-time workers to have health insurance. The ACA included multiple provisions intended to raise health insurance coverage rates, including a mandate that employers provide affordable coverage to full-time workers, a requirement that dependents be allowed to remain on their parents’ plan until age 26, extensions of Medicaid coverage, and the establishment of health insurance exchanges on which lower-income households could purchase subsidized coverage. Implementation of these provisions was associated with a decline in the full-time/part-time coverage gap from 6.5 percentage points in 2013 to 3.1 percentage points in 2021. Increases in Medicaid coverage and insurance purchased on the exchanges reduced were the largest contributors to the reduction in the full-time/part-time coverage gap. |
| JEL: | I13 I18 I30 J32 |
| Date: | 2024–10 |
| URL: | https://d.repec.org/n?u=RePEc:nbr:nberwo:33046 |
| By: | Ubaldi, Michele; Picchio, Matteo |
| Abstract: | We study the effect of mass shooting exposure on individuals' mental health by using the Panel Study of Income Dynamics. Our identification strategy relies on the quasi-randomness of mass shootings in a staggered difference-in-differences design. We compare changes in mental health outcomes of individuals living in affected cities with changes of matched individuals living in non-proximal and not affected cities. We find that mass shootings have a substantial adverse impact on mental health, which persists for up to six years. This impact is not statistically significant for Black individuals, whereas it is slightly more pronounced among women and older cohorts. |
| Keywords: | Mass shooting, mental health, difference-in-differences, dynamic effect |
| JEL: | C23 I18 K14 |
| Date: | 2024 |
| URL: | https://d.repec.org/n?u=RePEc:zbw:glodps:1510 |
| By: | Flynn, James (Miami University) |
| Abstract: | This paper documents an important unintended consequence of expanding contraceptive access; namely that it creates positive selection in the health of the children being born. I use a family planning intervention which gave thousands of long-acting reversible contraceptives to reproductive-age women in the St. Louis metropolitan area as a source of plausibly exogenous variation in contraceptive access to demonstrate that it reduced the rates of both extremely preterm births and infant mortality. I use both a synthetic control and synthetic difference-in-differences design, with my most conservative estimates suggesting that this program led to reductions of 2.5 extremely preterm births and 1.3 infant deaths per 1, 000 live births across St. Louis County, reductions of approximately 23% and 15% respectively. I find large reductions for both Black and White mothers, with Black mothers experiencing a greater reduction in magnitude, but smaller reductions as a percentage of the baseline rate. |
| Keywords: | contraceptive access, infant mortality, preterm birth, family planning |
| JEL: | J13 I18 I12 |
| Date: | 2024–09 |
| URL: | https://d.repec.org/n?u=RePEc:iza:izadps:dp17320 |
| By: | Effrosyni Adamopoulou; Jeremy Greenwood; Nezih Guner; Karen Kopecky |
| Abstract: | The role of friends in the US opioid epidemic is examined. Using data from the National Longitudinal Survey of Adolescent Health (Add Health), adults aged 25-34 and their high school best friends are focused on. An instrumental variable technique is employed to estimate peer effects in opioid misuse. Severe injuries in the previous year are used as an instrument for opioid misuse in order to estimate the causal impact of a person’s best friends’ opioid misuse on their own misuse. The estimated peer effects are significant: Having a best friend with a reported serious injury in the previous year increases the probability of own opioid misuse by around 7 percentage points in a population where 17 percent ever misuses opioids. The effect is concentrated among non-college graduates and peers with strong ties who are central in their friendship networks. Peer opioid misuse leads to deteriorating health, opioid addiction, and eventually death. |
| Keywords: | opioid, peer-group effects, friends, instrumental variables, Add Health, severe injuries. |
| JEL: | C26 D10 I12 J11 |
| Date: | 2024–01 |
| URL: | https://d.repec.org/n?u=RePEc:bon:boncrc:crctr224_2024_493v2 |
| By: | Hernández-Pizarro, Helena M.; Maynou, Laia |
| Abstract: | While the benefits of physical activity on health are well documented, in high-income countries 1 in 3 adults do not reach the recommended levels. Thus, policy makers have developed interventions to promote physical activity. The aim of this research is to evaluate the effectiveness of physical activity prescription on mental health outcomes, by studying an intervention that prescribes physical activity at the primary care level in Catalonia (PAFES). This intervention specifically targets the adult population with high cardiovascular risk. We use data from the Health Survey of Catalonia (2011–2016) and exploit the variation in the number of trained General Practitioners that prescribe physical activity. Our results show that physical activity prescription reduces the probability of suffering from poor mental health. This effect is mainly driven by females within the targeted population. We also explore the main effect (or the output) of the intervention. While PAFES increases the probability of patients undertaking high-level physical activity, it does not affect rates of sedentarism or minutes walked per day. Results are consistent when using alternative mental health outcome measures, including self-reported depression and anxiety. We conclude that the prescription of physical activity not only contributes to the improvement of physical health but is also a useful tool to help preserve mental wellbeing. |
| Keywords: | cardiovascular disease; general practitioners; mental health; physical activity; prescription |
| JEL: | I20 I18 I31 |
| Date: | 2024–12–31 |
| URL: | https://d.repec.org/n?u=RePEc:ehl:lserod:125665 |
| By: | Espinosa, Oscar; Friebel, Rocco; Bejarano, Valeria; Arias, Martha Liliana; Husereau, Don; Smith, Adrian |
| Abstract: | Colombia is among the countries with the most robust financial protection against personal health spending in the world, with out-of-pocket spending ranking lowest across OECD countries. We investigate the evolution, distribution, and persistence of health spending by age group, sex, health care setting, health condition and geographic region for over 19 million users of Colombia’s health system between 2013 and 2021 (contributory scheme). We use average patient-level expenditure data from the Health-Promoting Entities of the Ministry of Health and Social Protection. We applied multivariate statistical techniques such as multiple correspondence analysis, factor maps and correlations. For both sexes, average health expenditure increases gradually with age until 60 years, accelerating thereafter abruptly. Health conditions with the highest percentage of expenditure were those related to neoplasms, blood diseases, circulatory system, pregnancy, puerperium and perinatal period. We found that home-based care in Amazonía-Orinoquía is almost non-existent, and that outpatient care represents a high proportion in all age groups (over 65%) compared to the other regions. There is a strong persistence of expenditure from one year to the next (i.e. they can provide relevant information for prediction), especially in areas with a larger supply of health services such as Bogotá-Cundinamarca. To the authors’ knowledge, this is the most comprehensive and detailed micro-analysis of health spending that has been developed for a Latin American country to date. |
| Keywords: | C59; financial protection; health technologies; healthcare expenditures; multiple correspondence analysis; public policy |
| JEL: | H51 I18 C59 |
| Date: | 2024–10–12 |
| URL: | https://d.repec.org/n?u=RePEc:ehl:lserod:125891 |
| By: | Mello, Marco (University of Aberdeen); Moscelli, Giuseppe (University of Surrey); Laliotis, Ioannis (City University London); Sayli, Melisa (University of Surrey) |
| Abstract: | Retention of skilled workers is critical for the delivery of public services in high-stakes environments such as hospital care. We study how contractual pay terms affect the retention of trainee doctors in the English NHS and the relationship between trainee doctors' attrition and hospital quality. Our setting is a nationwide reform that reduced unsocial working hours pay rates. Using a longitudinal sample and a novel linkage of administrative datasets, our quasi difference-in-difference strategy leverages the pre-reform exposure of each trainee doctor to unsocial working hours and suggests that the implementation of the new pay terms led to a 6.7% increase in the annual number of trainee doctors leaving the English NHS. As plausible mechanism, we show that the reform was detrimental to pay satisfaction and increased trainee doctors intentions to change job outside healthcare. By exploiting the effect of the reform, we also document a positive association between trainee doctors' attrition and hospital mortality. |
| Keywords: | job contracts, employee attrition, pay satisfaction, on-the-job training, doctors, hospitals, patient mortality |
| JEL: | I11 J22 J41 J45 J81 C23 |
| Date: | 2024–10 |
| URL: | https://d.repec.org/n?u=RePEc:iza:izadps:dp17345 |
| By: | McDaid, David; Vidyasagaran, Aishwarya Lakshmi; Nasir, Muhammed; Walker, Simon; Wright, Judy; Muliyala, Krishna Prasad; Thekkumkara, Sreekanth; Huque, Rumana; Faisal, Mehreen Riaz; Benkalkar, Saumit; Kabir, Mohammod Akbar; Russell, Claire; Siddiqi, Najma |
| Abstract: | Background Mental disorders remain the most significant contributor to years lived with disability in South Asia, yet governmental health expenditure on mental health in South Asia remains very low with limited strategic policy development. To strengthen the case for action it is important to better understand the profound economic costs associated with poor mental health. Methods: We conducted a systematic review on the costs of all mental disorders, as well as intentional self-harm and suicide, in the World Bank South Asia Region. Ten global and South Asian databases as well as grey literature sources were searched. Results: 72 studies were identified, including 38 meeting high quality criteria for good reporting of costs. Of these, 27 covered India, five Pakistan, four Nepal and three Bangladesh and Sri Lanka. Most studies focused on depressive disorders (15), psychoses (14) and harmful alcohol use (7); knowledge of economic impacts for other conditions was limited. Profound economic impacts within and beyond health care systems were found. In 15 of 18 studies which included productivity losses to individuals and/or carers, these costs more than outweighed costs of health care. Conclusion: Mental disorders represent a considerable economic burden, but existing estimates are conservative as they do not consider long-term impacts or the full range of conditions. Modelling studies could be employed covering longer time periods and more conditions. Clear distinctions should be reported between out-of-pocket and health system costs, as well as between mental health service-specific and physical health-related costs. |
| Keywords: | mental health; South Asia; health economics; mental health policy |
| JEL: | J1 |
| Date: | 2024–12–31 |
| URL: | https://d.repec.org/n?u=RePEc:ehl:lserod:125476 |
| By: | Bancalari, Antonella; Bernal, Pedro; García, María Fernanda; Ibarrarán, Pablo; Sánchez-Monin, Emmanuelle; Zúñiga Brenes, Paola |
| Abstract: | This paper investigates the effects of releasing remoteness constraints on the accessibility and quality of maternal and infant healthcare. Through a field experiment, we provided complementary demand- and supply-side subsidies to improve healthcare for impoverished pregnant women residing in remote Nicaraguan communities. The subsidies increased the utilization of antenatal care by skilled providers, the quality of care received, institutional delivery, and postnatal care utilization, along with the quality of postnatal care received by mothers. Neonatal and infant mortality and fertility decreased in treated communities five years after the intervention was started. |
| Keywords: | remoteness;subsidies;maternal health;infant mortality |
| JEL: | D10 D04 I15 O12 O18 |
| Date: | 2024–09 |
| URL: | https://d.repec.org/n?u=RePEc:idb:brikps:13791 |
| By: | Pol Campos-Mercade; Armando N. Meier; Stephan Meier; Devin Pope; Florian H. Schneider; Erik Wengström |
| Abstract: | Whether monetary incentives to change behavior work and how they should be structured are fundamental economic questions. We overcome typical data limitations in a large-scale field experiment on vaccination (N = 5, 324) with a unique combi-nation of administrative and survey data. We find that guaranteed incentives of $20 increase uptake by 13 percentage points in the short run and 9 in the long run. Guaranteed incentives are more effective than lottery-based, prosocial, or individually-targeted incentives, though all boost vaccinations. There are no unintended consequences on future vaccination or heterogeneities based on vaccination attitudes and incentivized economic preferences. Further, administrative data on relatives shows substantial positive spillovers. Our findings demonstrate the great potential of incentives for improving public health and provide guidance on their design. |
| Keywords: | incentives, health behaviour, social preferences, prosociality, risk preferences, vaccination |
| JEL: | C93 D01 D62 I12 I18 |
| Date: | 2024 |
| URL: | https://d.repec.org/n?u=RePEc:ces:ceswps:_11379 |
| By: | Ifeanyichi, Martilord; Mosso Lara, Jose; Tenkorang, Phyllis; Kebede, Meskerem; Bognini, Maeve; Abdelhabeeb, Alshaheed; Amaechina, Uchenna Ogechi; Ambreen, Faiza; Sarabu, Shreeja; Oladimeji, Taiwo; Toguchi, Ana; Hargest, Rachel; Friebel, Rocco |
| Abstract: | BACKGROUND: Cost-effectiveness evidence is a critical tool to support resource allocation decisions. There is growing recognition that the development of benefit packages for surgical care should be guided by such evidence, particularly in resource-constraint settings. METHODS: We conducted a systematic review of evidence (Medline, Embase, Global Health, EconLit and grey literature) on the cost-effectiveness of surgery across low-income and middle-income countries published between January 2013 and January 2023. We included studies with minor and major therapeutic surgeries and minimally invasive intraluminal and endovascular interventions. We computed and compared the average cost-effectiveness ratios (ACERs) for different surgical interventions to the respective national gross domestic product per capita to determine cost-effectiveness and to common traditional public health interventions. RESULTS: We identified 87 unique studies out of 20 070 articles screened. Studies spanned 23 countries, with China (n=20), Thailand (n=12), Brazil (n=8) and Iran (n=8) accounting for about 55% of the evidence. Overall, the median ACERs across procedure groups ranged from I$17/disability-adjusted life year (DALY) for laparotomies to I$170 186/DALY for bariatric surgeries. Most of the ACER estimates were classified as cost-effective (89%) or very cost-effective (76%). Low-complexity surgical interventions compared favourably to common public health interventions. CONCLUSION: These findings reinforce the growing body of evidence that investments in surgery are economically smart. There remains however paucity of high-quality evidence that would allow decision-makers to assess the comparative cost-effectiveness of surgery and to determine best buys across a wide range of specialties and interventions. A concerted effort is needed to advance the generation and utilisation of economic evidence in the drive towards scale-up of surgical care across low-income and middle-income countries. |
| Keywords: | REF fund |
| JEL: | J1 |
| Date: | 2024–10–03 |
| URL: | https://d.repec.org/n?u=RePEc:ehl:lserod:125479 |
| By: | Oner Tulum (Academic-Industry Research Network); William Lazonick (Academic-Industry Research Network) |
| Abstract: | Mandated by the Inflation Reduction Act of 2022, the U.S. government through the Centers for Medicare and Medicaid Services (CMS) is negotiating with pharmaceutical companies over the "maximum fair price" of ten drugs in wide use by Medicare patients. Over the next few years, the number of drugs whose prices are subject to negotiations will increase. The pharmaceutical companies contend that a "fair" price would be a "value-based price" that enables the companies' shareholders to capture the value that the drug creates for society. Invoking the dominant "maximizing shareholder value" ideology, the argument for value-based pricing assumes that it is only a pharmaceutical company's shareholders who make the risky investments that fund drug innovation. Pharmaceutical executives and their lobbyists warn that a lowering of drug prices will reduce investments in new drugs. The purpose of this paper is to enable CMS negotiators to respond to these arguments by showing a) why drug-price regulation is required, given the relation between scale economies in supplying drugs and price inelasticity of drug demand; b) how the pharmaceutical companies with which they are negotiating prices are, in general, not using their profits from unregulated drug prices to fund drug innovation but rather to fund distributions to shareholders in the form of cash dividends and stock buybacks; c) that publicly listed pharmaceutical companies do not typically rely upon investment by shareholders to fund drug innovation; and d) that investment in drug innovation entails "collective and cumulative learning" in foundational and translational research that is both antecedent and external to the investments in clinical research that a pharmaceutical company may make to bring a safe and effective drug to market. |
| Keywords: | Inflation Reduction Act, drug prices, Medicare negotiations, investment in innovation, accessible and affordable medicines, foundational research, translational research, clinical research, collective and cumulative learning, stock buybacks, shareholder-value ideology, value-based pricing, value for society |
| JEL: | G30 G35 H40 H51 I10 I28 J24 L11 L12 L21 L50 L65 O30 P16 |
| Date: | 2024–09–09 |
| URL: | https://d.repec.org/n?u=RePEc:thk:wpaper:inetwp226 |
| By: | Edward W. Zhou (Bentley University); Paula G. Chaves da Silva (Bentley University); Debbie Quijada (Bentley University); Fred D. Ledley (Bentley University) |
| Abstract: | The Inflation Reduction Act (IRA) of 2022 contained landmark provisions authorizing government to negotiate a "maximum fair price" for selected Medicare Part D drugs considering the manufacturer's research and development costs, federal support for discovery and development, the extent to which the drugs address unmet medical needs, and other factors. This working paper describes federal investment in the discovery and development of the ten drugs selected for price negotiation in the first year of the IRA as well as the health value created through Medicare Part D spending on these drugs. We identified $11.7 billion in NIH funding for basic or applied research leading to approval of these drugs with median investment costs of $895.4 million/drug. This early public investment provided a median cost savings to industry of $1, 485 million/drug, comparable to reported levels of investment by industry. From 2017-2021, Medicare Part D spent $126.4 billion (median $10.7 billion) for these products before rebates. Excluding two products for diabetes, Medicare Part D spending was $97.4 billion and the total health value created was 650, 940 QALYs or $67.7 billion (WTP/QALY=$104K) representing a negative residual health value of -$29.7 billion (before rebates). We argue that a negotiated fair price should provide returns on both private and public investments in these products commensurate with the scale and risk of these investments, with the principal return on public sector investments being the residual health value (net price) accruing to those using the product. These empirical data provide a cost basis for negotiating a fair price that rewards early government investments in innovation and provides social value for the public. |
| Keywords: | Inflation Reduction Act, drug pricing, Medicare, federal funding, biomedical research, health value, social return on investment |
| JEL: | H43 H51 I10 I18 |
| Date: | 2024–02–28 |
| URL: | https://d.repec.org/n?u=RePEc:thk:wpaper:inetwp219 |
| By: | Motta, Matt (Boston University School of Public Health); Callaghan, Timothy; Ross, Jennifer; Yokum, David Vincent (North Carolina) |
| Abstract: | Infection with Respiratory Syncytial Virus (RSV) is associated with tens of thousands of hospitalizations in a typical year. Most US adults are not likely to experience severe cases of RSV infection, but adults aged 60 or older are at elevated risk of experiencing hospitalization or death due to RSV. While RSV vaccines are available for adults aged 60 or older, and have been shown to significantly reduce the likelihood that older adults experience severe cases of RSV, less than one quarter of those eligible have opted to receive the vaccine. In the context of RSV vaccination, Reversal Narrative (RN) messages share stories about individuals who previously refused to receive the vaccine, but – in response to personal negative health outcomes (“regret” RN messaging) and/or new scientific information (“rationalizing” RN messaging) – ultimately changed their mind. In a large and nationally representative survey (N = 1, 300) of US adults, as well as a state-representative survey (N = 850) of a highly vaccinated US state, we demonstrate that unvaccinated adults over the age of 60 are significantly more likely to intend to receive an RSV vaccine when exposed to regret-focused (but not rationalizing) RN messaging. We conclude by discussing the viability of RN messaging as a vaccine promotion tactic, and consider how researchers might partner with health communicators to explore their viability in a wide range of health contexts. |
| Date: | 2024–10–15 |
| URL: | https://d.repec.org/n?u=RePEc:osf:socarx:q34kj |
| By: | Cody Hyman (Bentley University); Henry Dao (Bentley University); Gregory Vaughan (Bentley University); Fred D. Ledley (Bentley University) |
| Abstract: | The Inflation Reduction Act of 2022 contains landmark provisions authorizing the government to negotiate the price of selected drugs covered by Medicare Part D. The biopharmaceutical industry has criticized these provisions as a threat to innovation arguing that reducing future revenues could disincentivize equity investment in biotechnology. This research examines the sensitivity of private and public equity investment in the biotechnology industry to drug price indices and market conditions from 2000-2022. The analysis shows that equity financing and valuation in the biotechnology industry were strongly associated with equity market conditions but not indices of either producer or consumer drug prices. These results do not support claims of an association between changing drug prices and the availability of equity capital to emerging biotechnology companies, which currently sponsor the majority of all clinical trials. These results add to evidence that the IRA may not have a negative impact on pharmaceutical innovation. |
| Keywords: | Inflation Reduction Act, drug prices, biotechnology, finance, valuation, investment |
| JEL: | I1 I18 H43 H51 I10 |
| Date: | 2024–06–28 |
| URL: | https://d.repec.org/n?u=RePEc:thk:wpaper:inetwp223 |