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Pricing in the Market for Anticancer Drugs

January 28, 2015 Comments off

Pricing in the Market for Anticancer Drugs
Source: National Bureau of Economic Research

Drugs like bevacizumab ($50,000 per treatment episode) and ipilimumab ($120,000 per episode) have fueled the perception that the launch prices of anticancer drugs are increasing over time. Using an original dataset of 58 anticancer drugs approved between 1995 and 2013, we find that launch prices, adjusted for inflation and drugs’ survival benefits, increased by 10%, or about $8,500, per year. Although physicians are not penalized for prescribing costly drugs, they may be reluctant to prescribe drugs with prices that exceed subjective standards of fairness. Manufacturers may set higher launch prices over time as standards evolve. Pricing trends may also reflect manufacturers’ response to expansions in the 340B Drug Pricing Program, which requires manufacturers to provide steep discounts to eligible providers.

Medicaid as an Investment in Children: What is the Long-Term Impact on Tax Receipts?

January 19, 2015 Comments off

Medicaid as an Investment in Children: What is the Long-Term Impact on Tax Receipts?
Source: National Bureau of Economic Research

We examine the long-term impact of expansions to Medicaid and the State Children’s Health Insurance Program that occurred in the 1980’s and 1990’s. With administrative data from the IRS, we calculate longitudinal health insurance eligibility from birth to age 18 for children in cohorts affected by these expansions, and we observe their longitudinal outcomes as adults. Using a simulated instrument that relies on variation in eligibility by cohort and state, we find that children whose eligibility increased paid more in cumulative taxes by age 28. These children collected less in EITC payments, and the women had higher cumulative wages by age 28. Incorporating additional data from the Medicaid Statistical Information System (MSIS), we find that the government spent $872 in 2011 dollars for each additional year of Medicaid eligibility induced by the expansions. Putting this together with the estimated increase in tax payments discounted at a 3% rate, assuming that tax impacts are persistent in percentage terms, the government will recoup 56 cents of each dollar spent on childhood Medicaid by the time these children reach age 60. This return on investment does not take into account other benefits that accrue directly to the children, including estimated decreases in mortality and increases in college attendance. Moreover, using the MSIS data, we find that each additional year of Medicaid eligibility from birth to age 18 results in approximately 0.58 additional years of Medicaid receipt. Therefore, if we scale our results by the ratio of beneficiaries to eligibles, then all of our results are almost twice as large.

Does the Environment Still Matter? Daily Temperature and Income in the United States

January 13, 2015 Comments off

Does the Environment Still Matter? Daily Temperature and Income in the United States (PDF)
Source: National Bureau of Economic Research (non-paywall version)

It is widely hypothesized that incomes in wealthy countries are insulated from environmental conditions because individuals have the resources needed to adapt to their environment. We test this idea in the wealthiest economy in human history. Using within-county variation in weather, we estimate the effect of daily temperature on annual income in United States counties over a 40-year period. We find that this single environmental parameter continues to play a large role in overall economic performance: productivity of individual days declines roughly 1.7% for each 1°C (1.8°F) increase in daily average temperature above 15°C (59°F). A weekday above 30°C (86°F) costs an average county $20 per person. Hot weekends have little effect. These estimates are net of many forms of adaptation, such as factor reallocation, defensive investments, transfers, and price changes. Because the effect of temperature has not changed since 1969, we infer that recent uptake or innovation in adaptation measures have been limited. The non-linearity of the effect on different components of income suggest that temperature matters because it reduces the productivity of the economy’s basic elements, such as workers and crops. If counties could choose daily temperatures to maximize output, rather than accepting their geographically- determined endowment, we estimate that annual income growth would rise by 1.7 percentage points. Applying our estimates to a distribution of “business as usual” climate change projections indicates that warmer daily temperatures will lower annual growth by 0.06-0.16 percentage points in the United States unless populations engage in new forms of adaptation.

Bias in Cable News: Real Effects and Polarization

January 12, 2015 Comments off

Bias in Cable News: Real Effects and Polarization (PDF)
Source: National Bureau of Economic Research (via Stanford University)

We jointly measure the persuasive effects of slanted news and tastes for like-minded news. The key ingredient is using channel positions as exogenous shifters of cable news viewership. Local cable positions affect viewership by cable subscribers. They do not correlate with viewership by local satellite subscribers, who are observably similar to cable subscribers. We estimate a model of voters who select into watching slanted news, and whose ideologies evolve as a result. We estimate that Fox News increases the likelihood of voting Republican by 0.9 points among viewers induced into watching four additional minutes per week by differential channel positions.

Retail — The Agglomeration of Bankruptcy

December 29, 2014 Comments off

The Agglomeration of Bankruptcy (PDF)
Source: National Bureau of Economic Research

This paper identifies a new channel through which bankrupt firms impose negative externalities on non-bankrupt peers. The bankruptcy and liquidation of a retail chain weakens the economies of agglomeration in any given local area, reducing the attractiveness of retail centers for remaining stores leading to contagion of financial distress. We find that companies with greater geographic exposure to bankrupt retailers are more likely to close stores in affected areas. We further show that the effect of these externalities on non-bankrupt peers is higher when the affected stores are smaller and are operated by firms with poor financial health.

Homophily, Group Size, and the Diffusion of Political Information in Social Networks: Evidence from Twitter

November 20, 2014 Comments off

Homophily, Group Size, and the Diffusion of Political Information in Social Networks: Evidence from Twitter (PDF)
Source: National Bureau of Economic Research (via University of Toronto)

In this paper, we investigate political communications in social networks characterized both by homophily–a tendency to associate with similar individuals–and group size. To generate testable hypotheses, we develop a simple theory of information diffusion in social networks with homophily and two groups: conservatives and liberals. The model predicts that, with homophily, members of the majority group have more network connections and are exposed to more information than the minority group. We also use the model to show that, with homophily and a tendency to produce like-minded information, groups are disproportionately exposed to like-minded information and the information reaches like-minded individuals more quickly than it reaches individuals of opposing ideologies. To test the hypotheses of our model, we analyze nearly 500,000 communications during the 2012 US elections in a social network of 2.2 million politically-engaged Twitter users. Consistent with the model, we find that members of the majority group in each state-level network have more connections and are exposed to more tweets than members of the minority group. Likewise, we find that groups are disproportionately exposed to like-minded information and that information reaches like-minded users more quickly than users of the opposing ideology.

Quantifying the Lasting Harm to the U.S. Economy from the Financial Crisis

October 22, 2014 Comments off

Quantifying the Lasting Harm to the U.S. Economy from the Financial Crisis (PDF)
Source: Stanford University and NBER

The financial crisis and ensuing Great Recession left the U.S. economy in an injured state. In 2013, output was 13 percent below its trend path from 1990 through 2007. Part of this shortfall — 3.0 percentage points of real GDP — was the result of lingering slackness in the labor market in the form of abnormal unemployment and substandard weekly hours of work. The single biggest contributor was a shortfall in business capital, which accounted for 3.9 percentage points. The second largest was a shortfall of 3.5 percentage points in total factor productivity. The fourth was a shortfall of 2.4 percentage points in labor-force participation. I discuss these four sources of the injury in detail, focusing on identifying state variables that may or may not return to earlier growth paths. The conclusion is optimistic about the capital stock and slackness in the labor market and pessimistic about reversing the declines in total factor productivity and the part of the participation shortfall not associated with the weak labor market.

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