Discovery, development, regulation and marketing of the medications that are used in health care and the economics of the pharmaceutical industry.

Biologic therapy adherence, discontinuation, switching, and restarting among patients with psoriasis in the US Medicare population

Mar. 22, 2016

Jalpa Doshi, Junko Takeshita, Lionel Pinto, Penxiang Li, Xinyan Yu, Preethi Rao, Hema N. Viswanathan, Joel M. Gelfand

In the Journal of the American Academy of Dermatology, Jalpa Doshi and colleagues, including Penxiang Li and Preethi Rao, investigate real-world utilization patterns of biologic therapy in Medicare beneficiaries with psoriasis. Studies indicate low adherence to biologics among patients with psoriasis, yet little is known about the adherence level in the Medicare population. Using data from the Medicare Chronic Condition Data Warehouse Part A, B, and D files with 12-month follow-up after index prescription, Doshi and colleagues conducted a retrospective claims analysis on 2707...

Psoriasis in the US Medicare Population: Prevalence, Treatment, and Factors Associated with Biologic Use

Jan. 29, 2016

Junko Takeshita, Joel Gelfand, Penxiang Li, Lionel Pinto, Xinyan Yu, Preethi Rao, Hema Viswanathan, Jalpa Doshi

In the Journal of Investigative Dermatology, Junko Takeshita and colleagues, including Preethi Rao and Jalpa Doshi, look at factors associated with the use of biologics and other treatments for psoriasis. They  analyzed claims from a nationally representative sample of Medicare beneficiaries with Part D drug coverage. The researchers find that Medicare Part D beneficiaries without a low-income subsidy (LIS) had 70% lower odds of having received biologics than those with LIS. Similarly, the odds of having received biologics were 69% lower among black patients compared with white...

Internalizing Behavioral Externalities: Benefit Integration in Health Insurance

Dec. 18, 2015

Amanda Starc, Robert Town

In an NBER working paper, Amanda Starc and Robert Town demonstrate the benefits of integrating medical and drug benefits in the Medicare Part D setting. They compare stand-alone prescription drug plans (PDPs, which cover only drugs) and Medicare Advantage-prescription drug (MA-PD) plans (which cover total medical expenditures).  They document that plans that cover all medical expenses spend more on drugs than plans that are only responsible for prescription drug spending, consistent with drug spending offsetting some medical costs. The effect is driven by drug categories that are likely to...

State Medicaid Spending on Sovaldi

Sep. 25, 2015

With a price tag of $1,000 per pill and $84,000 for a 12-week course of Sovaldi (sofosbuvir), Gilead Sciences prompted widespread concern about whether its new treatment for hepatitis C (HCV) would bankrupt public and private payers. These concerns were particularly significant for state Medicaid programs, which face both limited state budgets and high HCV prevalence among beneficiaries.

Using Genomic Information to Improve Public Health

Aug. 11, 2015
What exactly is precision medicine? When the human genome was sequenced more than a decade ago, it began a new era of medicine that is now known as precision medicine. Initially, it was called personalized medicine; however, the word “personalized” was replaced with “precision” because it caused confusion and was misinterpreted. The goal of precision medicine is not to develop preventions and treatments that are unique for each individual. The National Research Council defines precision medicine as a medical model that focuses on “identifying which approaches will be effective for which...

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.

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...

Presentation of Prescription and Nonprescription Opioid Overdoses to U.S. Emergency Departments

Feb. 26, 2015

Michael A. Yokell, M. Kit Delgado, Nicholas D. Zaller, N. Ewen Wang, Samuel K. McGowan, Traci Craig Green

In JAMA Internal Medicine, Kit Delgado and colleagues investigate characteristics of opioid overdose presentations to emergency departments. Opioid overdose is a leading cause of injury-related mortality in the United States. They analyze data from 2010 on 135,971 patients with opioid overdoses who were treated in emergency departments. The authors evaluate opioid type, patient characteristics, care utilization and clinical outcomes. They find that: two thirds of overdose cases involved prescription opioids, mortality was higher for overdoses with multiple opioids, most...