Research
Working papers
Abstract
Digital health technologies, such as Continuous Glucose Monitors (CGMs), are transforming the availability of patient-level data, potentially influencing healthcare markets more broadly. This paper examines how CGMs influence the insulin market, shedding light on the impact of digital health technologies on pharmaceutical demand, pricing, and innovation incentives. I develop and estimate a tractable model of supply and demand for insulin, embedding: (i) patient-specific learning about treatment performance through the digital device, (ii) physician-level learning about new insulin products based on patient experiences, and (iii) price bargaining by pharmaceutical companies and the regulator, both internalizing demand-side learning. Using comprehensive medical claims data from France, where expanded CGM coverage boosted technology adoption, I find that CGMs' patient-specific information steered insulin demand toward newer products, with limited information spillover to non-users. Manufacturers of drugs that benefited from higher perceived quality, thanks to the observability of these attributes, could negotiate higher drug prices. My findings indicate that the introduction of these new observable attributes into pharmaceutical demand can shift the relative profitability of drug innovation strategies, thereby shaping future pharmaceutical innovation.
Abstract
We study the role of tier design in Medicare Part D. In the period 2013-2017, plans expanded the number of tiers in their formularies from three/four to five and systematically shifted generics to higher tiers subject to higher cost sharing. The systematic tier upgrading caused significant increases in the out-of-pocket costs, up to 6 times for some generics. This resulted in additional average per-enrollee spending on generics of $76 in 2017, totalling $1.5 billion for the Part D population, and increased mortality by 5.4% due to reduced utilization of generics with documented mortality benefits.
Work in progress
Biologic drugs and learning-by-doing.
Joint with Pierre Dubois.
The consequences of monitoring drug abuse: Physicians behavior towards secured prescription pads
