NATIONAL BUREAU OF ECONOMIC RESEARCH
NATIONAL BUREAU OF ECONOMIC RESEARCH

Ariel Dora Stern

Harvard Business School
Morgan Hall 433
Boston, MA 02163
Tel: 617-495-2332

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NBER Working Papers and Publications

December 2017Characterizing the Drug Development Pipeline for Precision Medicines
with Amitabh Chandra, Craig Garthwaite
in Economic Dimensions of Personalized and Precision Medicine, Ernst Berndt, Dana Goldman, and John Rowe, editor
November 2017Characterizing the Drug Development Pipeline for Precision Medicines
with Amitabh Chandra, Craig Garthwaite: w24026
Precision medicines – therapies that rely on genetic, epigenetic, and protein biomarkers – create a better match between individuals with specific disease subtypes and medications that are more effective for those patients. These treatments are expected to be both more effective and more expensive than conventional therapies, implying that their introduction is likely to have a meaningful effect on health care spending patterns. In addition, precision medicines can change the expected profitability of therapies both by allowing more sophisticated pricing systems and potentially decreasing the costs of drug development through shorter and more focused trials. As a result, this could change the types of products that can be profitably brought to market. To better understand the landscape ...

Forthcoming: Characterizing the Drug Development Pipeline for Precision Medicines, Amitabh Chandra, Craig Garthwaite, Ariel Dora Stern. in Economic Dimensions of Personalized and Precision Medicine, Berndt, Goldman, and Rowe. 2017

August 2013Physician Beliefs and Patient Preferences: A New Look at Regional Variation in Health Care Spending
with David Cutler, Jonathan Skinner, David Wennberg: w19320
There is considerable controversy about the causes of regional variations in health care expenditures. We use vignettes from patient and physician surveys linked to fee-for-service Medicare expenditures to test whether patient demand-side factors or physician supply-side factors explain regional variations in spending. We find patient demand is relatively unimportant in explaining variation in spending after accounting for physician beliefs. Physician organizational factors matter, but the single most important factor is physician beliefs about treatment: 35 percent of Medicare end-of-life spending, 12 percent of spending for heart attack patients, and 12 percent of total Medicare spending, are associated with physician beliefs unsupported by clinical evidence.
 
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