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

E-Mail: EmailAddress: hidden: you can email any NBER-related person as first underscore last at nber dot org

NBER Working Papers and Publications

May 2018Characterizing 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
Precision medicines—therapies that rely on the use of genetic, epigenetic, and protein biomarkers—create a better match between patients with specific disease subtypes and medications that are more effective for those patients. This heterogeneity in response has implications for the decision to develop therapies, their pricing, the design of clinical trials, and the relative importance of smaller biotech companies versus more traditional companies in pursuing early-stage R&D. To understand the scope of these effects, we use a comprehensive database of over 130,000 global clinical trials and describe the drug development pipeline for precision medicines over the past two decades. We identify clinical trials for likely precision medicines (LPMs) as those that use one or more relevant biomark...
April 2018The Orphan Drug Act at 35: An Outlook for the 21st Century
with Nicholas Bagley, Amitabh Chandra, Craig Garthwaite
in Innovation Policy and the Economy, Volume 19, Josh Lerner and Scott Stern, editors
November 2017Characterizing the Drug Development Pipeline for Precision Medicines
with Amitabh Chandra, Craig Garthwaite: w24026
Precision medicines – therapies that rely on the use of genetic, epigenetic, and protein biomarkers – create a better match between patients with specific disease subtypes and medications that are more effective for those patients. This heterogeneity in response has implications for the decision to develop therapies, their pricing, the design of clinical trials, and the relative importance of smaller biotech companies versus more traditional companies in pursuing early stage R&D. To understand the scope of these effects, we use a comprehensive database of over 130,000 global clinical trials and describe the drug development pipeline for precision medicines over the past two decades. We identify clinical trials for likely precision medicines (LPMs) as those that use one or more relevant bio...
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. Using vignettes from patient and physician surveys linked to fee-for-service Medicare expenditures, this study asks whether patient demand-side factors or physician supply-side factors explain these variations. The results indicate that patient demand is relatively unimportant in explaining variations. Physician organizational factors matter, but the most important factor is physician beliefs about treatment. In Medicare, we estimate that 35 percent of spending for end-of-life care, and 12 percent of spending for heart attack patients (and for all enrollees) is associated with physician beliefs unsupported by clinical evidence.
 
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