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Real-world effects of Brexit. Cost of Obamacare = an election? Civil rights laws and health inequality. Chinese economic history as seen through eyeglasses. CHIP at risk? Last days of empire edition of HWR

What does “value” really mean?

An interesting article in Stat makes the important point that although there is much talk about “value” in the media and health policy world, the exact definition of “value” depends on your presepective. But a survey released Wednesday by the University of Utah shows that, in health care, value has no universal meaning — 88 percent of doctors…

The effect of medication nonadherence on progression-free survival among patients with renal cell carcinoma

Along with my co-authors Jeff Sullivan, Jacki Chou, Michael Neely, Justin Doan, and Ross Maclean I am happy to announce to publication our paper “The effect of medication nonadherence on progression-free survival among patients with renal cell carcinoma” in Cancer Management and Research.  The abstract is below. Objective: To examine how observed medication nonadherence to 2…

Off-label prescribing

How frequently are pharmaceuticals used off label?  Perhaps more than you think.  Although these figures are a bit dated, Tabarrok (2000) details the extent of off-label prescribing in the U.S. as follows: According to a study by the U.S. General Accounting Office, 56 percent of cancer patients have been given non-FDA-approved prescriptions, and 33 percent…

How reimbursement affects innovation

Below are some excerpts from seminal papers examining how changes in reimbursement or market size affect pharmaceutical innovation. Acemoglu and Lin (2004): Our estimates suggest that a 1 percent increase in the size of the potential market for a drug category leads to a 6 percent increase in the total number of new drugs entering the…

Progress on Obamacare Sign-ups

According to the N.Y. Times: Despite the Trump administration’s efforts to scale back the health law, about 300,000 more people have signed up for health insurance in the Affordable Care Act marketplaces in the first weeks of this enrollment period than last year. This is about a 25% increase from last year at this time.  However,…

Is Economics bogus science?

John Ioannidis has an interesting article in the L.A. Times titled “Economics isn’t a bogus science — we just don’t use it correctly.” Some excerpts are below: Most published studies use limited data. By a conservative estimate, the average study has 18% power to detect a modest association if one exists. Due to this low…

Why shopping for health insurance is hard

The premise is simple.  Create markets, let consumers choose the products that fit them best, and the competition will lead to higher quality and lower prices.  That is the premise behind the Affordable Care Act’s health insurance exchanges.  A necessary condition for this to work, however, is that patients have visibility into the quality and…

Physician use of “Choosing Wisely”

Choosing Wisely aims to identify low value services and advise physicians to avoid or at least be more conservative in the use of these services.  The ability to implement these changes, however, depends on physician awareness of these initiatives.  A paper by Colla and Mainor (2017) examines trends in awareness of the Choosing Wisely initiative:…