Medical Technology

Advances in drugs, devices, and biological products that change the way health care is delivered. LDI Senior Fellows study the adoption and diffusion of medical technologies and assesses their impact on costs and quality of care.

Getting More Food-Allergic Young Adults To Carry Their Epinephrine: A Behavioral Economics Approach

Sep. 3, 2015

As one of the estimated 2.5% of Americans with a food allergy, deciding my next meal, snack, or even beverage is no simple task. Remembering to carry emergency epinephrine is also no walk in the park. Young adults like me are particularly vulnerable to error related to their food allergies and likely to engage in risky behavior. And despite the risk of death by anaphylaxis, few individuals with severe food allergies carry their emergency epinephrine on a daily basis.

Fix Pennsylvania's Medicaid Policy on IUDs

Jun. 15, 2015

Cross-posted with the Philadelphia Inquirer

Imagine a woman in labor who goes to the hospital with a delivery plan she made in consultation with her obstetrician: yes to antibiotics in labor; no to an epidural for pain control; yes to neonatal circumcision; and yes to having an intrauterine device (IUD) placed immediately after childbirth.

What Does it Cost to Develop a Drug and Should We Really Care?

Jun. 10, 2015

Cross-posted with the Field Clinic blog

How much does it cost to develop a new drug? The Tufts Center for the Study of Drug Development periodically produces estimates for drugs that actually make it to market. Predictably, those estimates consistently generate a storm of criticism that the methodology behind them is opaque, and that they are, nevertheless, too high. The newest number is $2.6 billion (for 2013) - triple the estimate in 2003.

Adoption of Electronic Medical Record-Based Decision Support for Otitis Media in Children

Apr. 1, 2015

Alexander G. Fiks, Peixin Zhang, A. Russell Localio, Saira Khan, Robert W. Grundmeier, Dean J. Karavite, Charles Bailey, Evaline A. Alessandrini, Christopher B. Forrest

In Health Services Research, Alexander Fiks and colleagues, including Christopher Forrest, analyze the impact of feedback in improving adoption of clinical decision support (CDS). The work is part of a larger trial of the effectiveness of CDS for diagnosing and treating ear infections in children. While substantial investment in electronic health records (EHRs) has provided an unprecedented opportunity to use CDS, the impact of feedback on clinician use of CDS systems has not been well studied. The authors looked at EHR-based CDS adoption during 41,391 ear infection visits, and...

Ask Your Doctor? Direct-to-Consumer Advertising of Pharmaceuticals

Mar. 1, 2015

Michael Sinkinson, Amanda Starc

In a National Bureau of Economic Research working paper, Michael Sinkinson and Amanda Starc assess the impact of direct-to-customer television advertising by pharmaceutical companies. The authors analyze the effectiveness of TV advertising for anti-cholesterol drugs known as statins, exploiting a natural experiment created by shocks to local advertising markets from the political advertising cycle, as well as a regulatory intervention affecting a single product. Their analysis finds that a 10% increase in the number of ads run by a particular firm leads to a 0.76% increase in revenue. The...

Hidden in Plain Sight: A Crowdsourced Public Art Contest to Make Automated External Defibrillators More Visible

Feb. 24, 2015

Raina Merchant, Heather Griffis, Yoonhee Ha, Austin Kilaru, Allison Sellers, John Hershey, Shawndra Hill, Emily Kramer-Golinkoff, Lindsay Nadkarni, Margaret Debski, Kevin Padrez, Lance Becker, David Asch

Raina Merchant and colleagues want to raise awareness about automated external defibrillators (AEDs) and use artwork to make AED locations more memorable. In a recent article in the American Journal of Public Health, Merchant et al use an online crowdsourcing design contest -- the Defibrillator Design Challenge -- to engage the public to this end. The goal of the project was not to install designs submitted as part of the contest, but to test whether the public would create them, vote on them, and share them. It is a follow-up to...

Cross-Border Effects of State Health Technology Regulation

Feb. 11, 2015

Jill R. Horwitz, Daniel Polsky

In the American Journal of Health Economics, LDI Executive Director Daniel Polsky and Jill R. Horwitz (UCLA School of Law) explore whether state Certificate of Need (CON) laws have an effect on the supply of medical technology in neighboring states. They studied whether MRI providers disproportionately locate in unregulated states in counties that border states regulated by CON licensing laws. They found a sizable cross-border effect: among counties located on state borders where one state regulates MRI entry and the other state does not, there is more likely to be an MRI provider in the...

Addressing Cost Barriers to Medications: A Survey of Patients Requesting Financial Assistance

Feb. 4, 2015

David Grande, Margaret Lowenstein, Madeleine Tardif, Carolyn Cannuscio

In the American Journal of Managed Care, David Grande and colleagues assess decision-making preferences of patients who face cost-related barriers to care or medication. Specifically, the authors evaluate which health care actors patients trust most to evaluate cost-efficacy tradeoffs and screen for cost barriers using administrative records. The authors conducted a survey of 1,400 patients (adults with a chronic disease seeking financial assistance) who rated a clinical vignette describing how a clinical decision was made in the context of a cost-efficacy tradeoff. Results show that...

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