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Health Economics

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https://www.readbyqxmd.com/read/28726348/state-insurance-mandates-and-off-label-use-of-chemotherapy
#1
Fabrice Smieliauskas, Hari Sharma, Connor Hurley, Jonas A de Souza, Ya-Chen Tina Shih
Access to cancer drugs used off-label is important to cancer patients but may drive up healthcare costs with little evidence of clinical benefit. We hypothesized that state health insurance mandates for private insurers to provide coverage for off-label use of cancer drugs cause higher rates of off-label use. We used Truven MarketScan data from 1999 to 2007 on utilization of 35 infused chemotherapy drugs in private health plans in the United States, covering the period when eight states implemented off-label coverage laws...
July 20, 2017: Health Economics
https://www.readbyqxmd.com/read/28719096/the-effect-of-state-laws-designed-to-prevent-nonmedical-prescription-opioid-use-on-overdose-deaths-and-treatment
#2
Ioana Popovici, Johanna Catherine Maclean, Bushra Hijazi, Sharmini Radakrishnan
Nonmedical use of prescription opioids has reached epidemic levels in the United States and globally. In response, federal, state, and local governments are taking actions to address substantial increases in prescription opioid addiction and its associated harms. This study examines the effect of two state laws specifically designed to curtail access to prescription opioids to nonmedical users: pain management clinic and doctor shopping laws. We use administrative data on overdose deaths and admissions to specialty substance use disorder treatment coupled with a differences-in-differences design...
July 18, 2017: Health Economics
https://www.readbyqxmd.com/read/28695631/extending-decomposition-analysis-to-account-for-unobserved-heterogeneity-and-persistence-in-health-behavior-income-related-smoking-inequality-among-swedish-women
#3
Gustav Kjellsson
This article suggests an enrichment of the standard method for decomposition of the concentration index to account for unobserved heterogeneity and persistence in health behavior. As the underlying regression model in the decomposition, this approach uses a dynamic random-effect probit that both consider individual heterogeneity, using a Mundlak type of specification, and applies a simple solution to account for smoking persistence. I illustrate the suggested approach using a panel of Swedish women in Statistics Sweden's Survey of Living Conditions for one vital health-related behavior, smoking...
July 10, 2017: Health Economics
https://www.readbyqxmd.com/read/28695605/returns-to-scientific-publications-for-pharmaceutical-products-in-the-united-states
#4
Julia F Slejko, Anirban Basu, Sean D Sullivan
Drug-specific clinical and health economic and outcomes research (HEOR) publications have amassed, but their effect on drug sales is largely unknown. We estimated the impact of publications on pharmaceutical sales in 3 markets (statins, rheumatoid arthritis, and asthma drugs) with varying generic competition. An event-study approach with fixed effects and difference-in-fixed-effects modeling was used to estimate the causal effects of drug-specific publications on subsequent quarter's drug-specific sales and volume...
July 10, 2017: Health Economics
https://www.readbyqxmd.com/read/28685925/what-goes-wrong-with-the-allocation-of-domestic-and-international-resources-for-hiv
#5
Olivier C Sterck
This paper examines how domestic and international financing for HIV is, and ought to be, distributed. We build a theoretical framework that decomposes domestic and international financing for HIV into nonlinear functions of national income, HIV prevalence, and government effectiveness. We test this model, paying particular attention to nonlinearities and to problems of bad controls, multicollinearity, and reverse causality. Finally, we use the fitted values of quartile regressions to study how much countries could reasonably pay domestically and how much they should receive from donors...
July 7, 2017: Health Economics
https://www.readbyqxmd.com/read/28685902/can-pay-for-performance-to-primary-care-providers-stimulate-appropriate-use-of-antibiotics
#6
Lina Maria Ellegård, Jens Dietrichson, Anders Anell
Antibiotic resistance is a major threat to public health worldwide. As the healthcare sector's use of antibiotics is an important contributor to the development of resistance, it is crucial that physicians only prescribe antibiotics when needed and that they choose narrow-spectrum antibiotics, which act on fewer bacteria types, when possible. Inappropriate use of antibiotics is nonetheless widespread, not least for respiratory tract infections (RTI), a common reason for antibiotics prescriptions. We examine if pay-for-performance (P4P) presents a way to influence primary care physicians' choice of antibiotics...
July 7, 2017: Health Economics
https://www.readbyqxmd.com/read/28685890/impact-of-the-phased-abolition-of-co-payments-on-the-utilisation-of-selected-prescription-medicines-in-wales
#7
M Fasihul Alam, David Cohen, Frank Dunstan, Dyfrig Hughes, Philip Routledge
We have taken advantage of a natural experiment to measure the impact of the phased abolition of prescription co-payments in Wales. We investigated 3 study periods covering the phased abolition: from £6 to £4, £4 to £3, and £3 to £0. A difference-in-difference modelling was adopted and applied to monthly UK general practice level dispensing data on 14 selected medicines which had the highest percentage of items dispensed subject to a co-payment prior to abolition. Dispensing from a comparator region (North East of England) with similar health and socio-economic characteristics to Wales, and where prescription co-payments continued during the study periods, was used to isolate any non-price effects on dispensing in Wales...
July 7, 2017: Health Economics
https://www.readbyqxmd.com/read/28660666/factors-associated-with-the-pricing-of-childhood-vaccines-in-the-u-s-public-sector
#8
Weiwei Chen, Mark Messonnier, Fangjun Zhou
Vaccine purchase cost has grown substantially over the last few decades. A closer look at vaccine prices reveals that not all vaccines shared the same increasing pattern. Various factors, such as vaccine attributes, competition, and supply shortages, could relate to price changes. In this study, we examined whether a variety of factors influenced the prices of noninfluenza childhood vaccines purchased in the public sector from 1996 to 2014. The association differed among price-capped vaccines and combination vaccines...
June 29, 2017: Health Economics
https://www.readbyqxmd.com/read/28660657/pay-less-consume-more-the-price-elasticity-of-home-care-for-the-disabled-elderly-in-france
#9
Quitterie Roquebert, Marianne Tenand
Little is known about the price sensitivity of demand for home care of the disabled elderly. We partially fill this knowledge gap by using administrative data on the beneficiaries of the main French home care subsidy program in a department and exploiting interindividual variation in provider prices. We address the potential endogeneity of prices by taking advantage of the unequal spatial coverage of providers and instrumenting price by the number of municipalities served by a provider. We estimate a price elasticity of around -0...
June 29, 2017: Health Economics
https://www.readbyqxmd.com/read/28660643/graduating-into-a-downturn-are-physicians-recession-proof
#10
Alice Chen, Anthony Lo Sasso, Michael R Richards
An extensive literature documents immediate and persistent adverse labor market outcomes for individuals graduating into an economic downturn, but these effects are heterogeneous across sectors, occupations, and skill levels. In particular, the impact of recessions on the labor market outcomes for new physician graduates remains unknown. We leverage a unique dataset on New York physicians to analyze if and how the Great Recession impacted the labor market of physicians who have completed their residency and fellowship training and are seeking their first job...
June 29, 2017: Health Economics
https://www.readbyqxmd.com/read/28660631/yes-health-is-important-but-as-much-for-its-importance-via-social-life-the-direct-and-indirect-effects-of-health-on-subjective-well-being-in-chronically-ill-individuals
#11
Admassu N Lamu, Jan Abel Olsen
There is an increasing evidence that health-related quality of life, income, and social relationships are important to our subjective well-being (SWB). Little is known, however, about the specific indirect pathways that link health to SWB via social relationships and income. On the basis of a unique data set of 7 disease groups from 6 OECD-countries (N = 6,173), we investigate the direct and indirect effects of health on SWB by using structural equation modeling. Three alternative measures of health are used: For generic instruments (EQ-5D-5L; SF-6D), the total indirect effect was stronger (0...
June 29, 2017: Health Economics
https://www.readbyqxmd.com/read/28660624/how-do-hospital-specialty-characteristics-influence-health-system-responsiveness-an-empirical-evaluation-of-in-patient-care-in-the-italian-region-of-emilia-romagna
#12
Gianluca Fiorentini, Silvana Robone, Rossella Verzulli
Studies of health system responsiveness mostly focus on the demand side by investigating the association between sociodemographic characteristics of patients and their reported level of responsiveness. However, little is known about the influence of supply-side factors. This paper addresses that research gap by analysing the role of hospital-specialty characteristics in explaining variations in patients' evaluation of responsiveness from a sample of about 38,700 in-patients treated in public hospitals within the Italian Region of Emilia-Romagna...
June 29, 2017: Health Economics
https://www.readbyqxmd.com/read/28627808/evaluation-of-a-pharmaceutical-risk-sharing-agreement-when-patients-are-screened-for-the-probability-of-success
#13
Reza Mahjoub, Fredrik Ødegaard, Gregory S Zaric
We analyze a game-theoretic model of a risk-sharing agreement between a payer and a pharmaceutical firm. The drug manufacturer chooses the price while the payer sets the rebate rate and decides which patients are eligible for treatment. The manufacturer provides the payer with a rebate for nonresponding patients. We generalize on the existing literature, by making both price and rebate rate decision variables, allowing the rebate rate to be different from 100%, and incorporating 2 types of administrative costs...
June 19, 2017: Health Economics
https://www.readbyqxmd.com/read/28627730/does-involvement-of-local-ngos-enhance-public-service-delivery-cautionary-evidence-from-a-malaria-prevention-program-in-india
#14
Ashis Das, Jed Friedman, Eeshani Kandpal
Partnerships between government and non-state actors that aim to enhance the quality or efficiency of service delivery are increasingly common in today's development policy landscape. We investigate the impacts of such an approach using data from an experimental supportive intervention to India's malaria control program that leveraged local non-state capacity in order to promote mosquito net usage and recommended fever care-seeking patterns. The supportive activities were conducted simultaneously by 3 NGOs, contracted out by the Indian government, in 2 endemic districts in the state of Odisha...
June 19, 2017: Health Economics
https://www.readbyqxmd.com/read/28620975/decision-heuristic-or-preference-attribute-non-attendance-in-discrete-choice-problems
#15
Sebastian Heidenreich, Verity Watson, Mandy Ryan, Euan Phimister
This paper investigates if respondents' choice to not consider all characteristics of a multiattribute health service may represent preferences. Over the last decade, an increasing number of studies account for attribute non-attendance (ANA) when using discrete choice experiments to elicit individuals' preferences. Most studies assume such behaviour is a heuristic and therefore uninformative. This assumption may result in misleading welfare estimates if ANA reflects preferences. This is the first paper to assess if ANA is a heuristic or genuine preference without relying on respondents' self-stated motivation and the first study to explore this question within a health context...
June 16, 2017: Health Economics
https://www.readbyqxmd.com/read/28620934/fairness-in-cost-benefit-analysis-a-methodology-for-health-technology-assessment
#16
Anne-Laure Samson, Erik Schokkaert, Clémence Thébaut, Brigitte Dormont, Marc Fleurbaey, Stéphane Luchini, Carine Van de Voorde
We evaluate the introduction of various forms of antihypertensive treatments in France with a distribution-sensitive cost-benefit analysis. Compared to traditional cost-benefit analysis, we implement distributional weighting based on equivalent incomes, a new concept of individual well-being that does respect individual preferences but is not subjectively welfarist. Individual preferences are estimated on the basis of a contingent valuation question, introduced into a representative survey of the French population...
June 16, 2017: Health Economics
https://www.readbyqxmd.com/read/28618448/out-of-sight-but-not-out-of-mind-home-countries-macroeconomic-volatilities-and-immigrants-mental-health
#17
Ha Trong Nguyen, Luke Brian Connelly
We provide the first empirical evidence that better economic performances by immigrants' countries of origin, as measured by lower consumer price index (CPI) or higher gross domestic product, improve immigrants' mental health. We use an econometrically-robust approach that exploits exogenous changes in macroeconomic conditions across immigrants' home countries over time and controls for immigrants' observable and unobservable characteristics. The CPI effect is statistically significant and sizeable. Furthermore, the CPI effect diminishes as the time since emigrating increases...
June 15, 2017: Health Economics
https://www.readbyqxmd.com/read/28599353/restricting-access-to-alcohol-and-public-health-evidence-from-electoral-dry-laws-in-brazil
#18
Marcos Y Nakaguma, Brandon J Restrepo
We analyze the impact of short-term alcohol bans on road traffic accidents, traffic injuries, and hospital admissions. We focus on the 2012 Municipal Elections in Brazil, during which 11 out of 27 states imposed on its 2,733 municipalities the decision to adopt alcohol bans. Using day-level data on municipalities, we find that alcohol bans caused substantial reductions in road crashes (19%), traffic injuries (43%), and traffic-related hospitalizations (17%). An analysis of traffic-related hospitalization costs allows us to estimate the lower bound of the negative externality associated with excessive alcohol consumption in this context, which reveals that electoral dry laws saved Brazil's public healthcare system $100,000 per day...
June 9, 2017: Health Economics
https://www.readbyqxmd.com/read/28568967/globalisation-and-national-trends-in-nutrition-and-health-a-grouped-fixed-effects-approach-to-intercountry-heterogeneity
#19
Lisa Oberlander, Anne-Célia Disdier, Fabrice Etilé
Using a panel dataset of 70 countries spanning 42 years (1970-2011), we investigate the distinct effects of social globalisation and trade openness on national trends in markers of diet quality (supplies of animal proteins, free fats and sugar, average body mass index, and diabetes prevalence). Our key methodological contribution is the application of a grouped fixed-effects estimator, which extends linear fixed-effects models. The grouped fixed-effects estimator partitions our sample into distinct groups of countries in order to control for time-varying unobserved heterogeneity that follows a group-specific pattern...
June 1, 2017: Health Economics
https://www.readbyqxmd.com/read/28568843/is-there-additional-value-attached-to-health-gains-at-the-end-of-life-a-revisit
#20
Dorte Gyrd-Hansen
Researchers have in recent years sought to establish whether the general public value treatment at the end of life (EOL) more highly than other treatments. Results are mixed, with social preferences most often exhibiting lack of preferences for EOL treatments. This null result may be driven by the often applied study design, where respondents are to choose between treatments targeting patients with varying fixed life expectancies. When remaining life is certain and salient, a rule-of-rescue sentiment may drive preferences across all scenarios...
June 1, 2017: Health Economics
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