1,721,022 research outputs found
Investment in health technologies in a competitive model with real options
No full textThis paper adopts a real options approach to study the optimal timing of investment in new technologies by health care providers competing for patients and the role of alternative payment systems in the adoption decision. The innovative technology provides a better health outcome, thus attracting a larger number of patients. On the other hand, at the early stages of innovation it is assumed to involve a larger degree of uncertainty and higher costs. The role of the payment system turns out not always to be intuitive. In particular, it is shown that a more generous scheme does not always induce earlier investment. By comparing the competitive solution with the social optimal timing, some policy implications are finally discussed
Technology adoption, quality and health care costs: a review of the literature
No full textThis paper provides a review of the literature that has investigated the mechanisms underlying the diffusion of new health care technologies and its implications. The importance of regulation and of the intensity of competitive pressures associated with each possible regulatory solution have been confirmed both theoretically and empirically. Nonetheless, the lack of consistency among the results of different studies, observed in some cases, may suggest that more work is needed. Moreover, the specific characteristics of different diseases and of the corresponding technologies may play an important role as well. Specific sections are included in the paper to review contributions that address two issues that have probably received less attention than they deserve: the welfare implications of the diffusion of new medical technologies and the timing of adoption
An extension of the real option approach to the evaluation of health care technologies: the case of positron emission tomography
No full textCost–effectiveness analysis, Real options, Positron emission tomography, C61, D61, D81, I12,
Value-Based Pricing Alternatives for Personalised Drugs: Implications of Asymmetric Information and Competition
No full textThe market for new drugs is changing: personalised drugs will increase the heterogeneity in patients’ responses and, possibly, costs. In this context, price regulation will play an increasingly important role. In this article, we argue that personalised medicine opens new scenarios in the relationship between value-based prices, regulation and industry listing strategies. Our focus is on the role of asymmetry of information and competition. We show that, if the firm has more information than the payer on the heterogeneity in patients’ responses and it adopts a profit-maximising listing strategy, the outcome may be independent of the choice of the type of value-based price. In this case, the information advantage that the manufacturer has prevents the payer from using marginal value-based prices to extract part of the surplus. However, in a dynamic setting where competition by a new entrant is possible, the choice of the type of value-based price may matter. We suggest that more research should be devoted to the dynamic analysis of price regulation for personalised medicines
Investment in Health Technologies: a Real Option Approach
No full textL'obiettivo di questo lavoro e' l'estensione dell'approccio basato su opzioni reali alla valutazione delle tecnologie sanitarie. l'approccio al problema e' duplice. da un lato si vuole capire quale contributo questo sviluppo possa fornire alla comprensione dei meccanismi di adozione e diffusione di nuove tecnologie in sanità. l'altro obiettivo e' realizzare una concreta applicazione di questo approccio alla valutazione, che e' ancora assente nella letteratura di economia sanitaria. la tecnologia scelta per l'applicazione è la positron emission tomography (pet).This work aims to extend the real option approach to the evaluation of health care technologies. The aim is to do this from two different points of view. On one side we are interested in understanding what insights taking option values into account provides in the study of adoption behaviour by providers. On the other side, we aim to provide an application of this approach to the economic evaluation of a specific medical technology, which is still missing in the health economics literature. The technology that has been chosen for the application is positron emission tomography (pet)
Dynamic, economic approaches to HTA under uncertainty. WP Series University of Verona Department of Economics (ISSN 2036-2919), 03/2011
No full textA simple, two period framework is used to interpret existing contributions to the literature on decision rules for HTA under uncertainty and to contrast them with a dynamic, economic model solved using backward induction
Who should monitor job sick leave?
No full textWe use a large and unique administrative dataset from Italy, covering the period 2009-2014, to investigate opportunistic behavior (moral hazard) and the effectiveness of monitoring policies related to insurance against illness-related income losses. The analysis is based on the outcome of mandatory medical visits aimed at verifying the health status of employees during sickness spells. We find that employers are more effective than the public insurer in selecting sickness episodes to monitor. However, a reduction in the number and a better targeting of visits with the support of appropriate statistical tools may close the gap. We discuss the impact of using direct measures of health, such as the outcome of a medical visit, on the study of the determinants of opportunistic behavior and argue that simply looking at days of work lost, without appropriately controlling for health status, may lead to misleading conclusions if the goal is studying moral hazard
Job Sick Leave: Detecting Opportunistic Behavior
No full textWe utilize a large administrative dataset of sickness leave in Italy, i) to investigate whether private firms are more effective than the public insurer in choosing who to monitor, and ii) to study the correlation between potentially opportunistic behavior and the observable characteristics of the employee. We find that private employers are more likely to select into monitoring employees who are fit for work despite being on sick leave, if the public insurer is not supported by any data-driven tool. However, the use of a scoring mechanism, based on past records, allows the public insurer to be as effective as the employer. This result suggests that the application of machine learning to appropriate databases may improve the targeting of public monitoring to detect opportunistic behavior. Concerning the association between observable characteristics and potentially opportunistic behavior, we find that males, employees younger than 50, those on short leaves or without a history of illness are more likely to be found fit for work
DRGs: the link between investment in technologies and appropriateness. WP Series University of Verona Department of Economics (ISSN 2036-2919), 31/2012
No full textStatic and dynamic effciency of irreversible health care investments under alternative payment rules
No full textThe paper studies the incentive for providers to invest in new health care technologies under alternative payment systems, when the patients' benefits are uncertain. If the reimbursement by the purchaser includes both a variable (per patient) and a lump-sum component, efficiency can be ensured both in the timing of adoption (dynamic) and the intensity of use of the technology (static). If the second instrument is unavailable, a trade-off may emerge between static and dynamic efficiency.
In this context, we also discuss how the regulator could use the control of the level of uncertainty faced by the provider as an instrument to mitigate the trade-off between static and dynamic efficiency. Finally, the model is calibrated to study a specific technology
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