Regulating Conflicts of Interest in Medicine Through Public Disclosure: Evidence from a Physician Payments Sunshine Law

2021 ◽  
Author(s):  
Matthew Chao ◽  
Ian Larkin
Keyword(s):  
Conflicts Of Interest ◽  
Healthcare Management ◽  
Public Disclosure ◽  
Brand Name ◽  
Data Set ◽  
Pharmaceutical Firms ◽  
Drug Classes ◽  
Healthcare Administrators ◽  
The Many ◽  
Brand Name Drugs

Hospital and healthcare administrators name high prescription drug costs as one of their largest problems. A significant body of research demonstrates that meals and honoraria from pharmaceutical firms to physicians leads to higher prescribing of expensive, brand name drugs, despite little difference in efficacy. Some administrators and scholars have advocated for mandatory disclosure of these payments in order to reduce this conflict of interest, but many practitioners believe disclosure has little effect on prescribing, and the empirical evidence is mixed. This paper uses a quasi-experiment of a 2009 payment disclosure policy in Massachusetts to estimate the causal impact of public disclosure on prescribing. The comprehensive data set includes all retail prescriptions for 262 drugs in nine drug classes written by 5,730 physicians in five states over 48 months. We show a significant postdisclosure reduction in brand name drug prescriptions by Massachusetts physicians, relative to control physicians in other states. These effects are driven by heavy prescribers of brand name drugs in the prepolicy period, particularly for drugs with large prepolicy sales forces. Effects are also detected before the first data were released, implying that the effects are not because patients or administrators responded to the disclosed payments. Instead, some physicians may have changed their payments and prescriptions behavior to avoid appearing biased. Taken in tandem with the many studies showing that pharmaceutical industry payments influence prescribing, this study suggests a strong role for mandatory public disclosure in reducing conflicts of interest in medicine and costly prescribing of brand name drugs. This paper was accepted by Stefan Scholtes, healthcare management.

scholarly journals Has the Credibility of the Social Sciences Been Credibly Destroyed? Reanalyzing the “Many Analysts, One Data Set” Project

2021 ◽  
Vol 7 ◽  
pp. 237802312110244
Author(s):  
Katrin Auspurg ◽  
Josef Brüderl
Keyword(s):  
Social Sciences ◽  
Causal Reasoning ◽  
Research Question ◽  
Social Science Research ◽  
Science Research ◽  
Skin Tone ◽  
Data Set ◽  
The Social ◽  
The Many ◽  
Definition Of

In 2018, Silberzahn, Uhlmann, Nosek, and colleagues published an article in which 29 teams analyzed the same research question with the same data: Are soccer referees more likely to give red cards to players with dark skin tone than light skin tone? The results obtained by the teams differed extensively. Many concluded from this widely noted exercise that the social sciences are not rigorous enough to provide definitive answers. In this article, we investigate why results diverged so much. We argue that the main reason was an unclear research question: Teams differed in their interpretation of the research question and therefore used diverse research designs and model specifications. We show by reanalyzing the data that with a clear research question, a precise definition of the parameter of interest, and theory-guided causal reasoning, results vary only within a narrow range. The broad conclusion of our reanalysis is that social science research needs to be more precise in its “estimands” to become credible.

The Optimal Diversification Strategy in Pharmaceutical Industry: Balance-centred or Hetero-centred?

2021 ◽  
pp. 097172182110056
Author(s):  
Keungoui Kim ◽  
Junseok Hwang ◽  
Sungdo Jung ◽  
Eungdo Kim
Keyword(s):  
Business Performance ◽  
Business Environment ◽  
Product Diversification ◽  
Diversification Strategy ◽  
Firm Level ◽  
Data Set ◽  
Pharmaceutical Firms ◽  
Level Data ◽  
Market Product ◽  
High Uncertainty

Due to high uncertainty of product development and business environment, firm-level diversification has been regarded as one of the most effective methods in pharmaceutical firms. In previous study, firm-level diversification was discussed by different value chains of market, product, and technology. However, in most cases, the diversification itself was adopted in a simple manner although its property contains different aspects and the results varies depending on the diversity property of selected index. In addition, the existing approach for measuring firm’s product/market diversification using sales information distinguished by standard industry classification cannot provide direct implication as different strategies are made for market and product diversification. Therefore, this study examines the effects of firm-level diversification on business and innovation performances in pharmaceutical firms by considering (1) three diversification types: market, product, and technology, (2) clear separation between market and product diversification, and (3) two diversification perspectives: balance-centred and hetero-centred. For empirical analysis, an integrated firm-level data set combining from Medtrack, Orange Book, Compustat and Total Patent database is used. From the result, in case of market diversification, less market heterogeneity causes significant influence on business performance. For product and technology, a concentrated and greater heterogeneity of product diversification are turned out to promote business performance, while the more intensive and heterogeneous technology diversification has been shown to improve innovation performance.

scholarly journals Impact of Working Capital Management on Corporate Profitability- Empirical Evidence from Pharmaceutical Industry of Bangladesh

2018 ◽  
Vol 10 (9) ◽  
pp. 136
Author(s):  
Rakibul Islam ◽  
Mohammad Emdad Hossain ◽  
Mohammad Nazmul Hoq ◽  
Md. Morshedul Alam
Keyword(s):  
Regression Analysis ◽  
Correlation Matrix ◽  
Negative Impact ◽  
Pearson Correlation ◽  
Capital Management ◽  
Working Capital ◽  
Data Set ◽  
Working Capital Management ◽  
Pharmaceutical Firms ◽  
The Impact

Working capital management plays centric role in enhancing operational efficiency and their ultimate profitability. Globally financial managers have been searching the proper way on how to utilize working capital components which prolong profitability. The purpose of this study is to assess the impact of working capital components on profitability indicators of selected pharmaceutical firms in Bangladesh. The paper used financial data of 9 pharmaceutical firms listed in Dhaka stock exchange (DSE) covered 2011-2015. Two methods were used in this study for analysis data set. Firstly, to measure the relationship between selected variables Pearson Correlation matrix was used. Secondly, multiple regression analysis was used to investigate the impact working capital components on profitability of selected pharmaceutical firms. The study also conducted Durbin Watson test to assess autocorrelation of selected variables. In this study the correlation matrix identified a negative correlation between working capital components and profitability, whereas regression analysis found number of days account receivable (AR) had significant positive and current ratio (CR) and debt ratio (DR) had appeared a significant negative impact on profitability.

scholarly journals The Management and Administrative Practices Resulting in the Exit of Nurses from the Irish Healthcare System – a Review

2020 ◽  
Vol 3 ◽  
Author(s):  
Syed A Jilani
Keyword(s):  
Healthcare System ◽  
Well Being ◽  
Healthcare Management ◽  
Ageing Population ◽  
Administrative Practices ◽  
System A ◽  
The Government ◽  
Being There ◽  
The Many ◽  
Mental Well Being

The exit of nurses from the Irish healthcare system is a growing concern especially coupled with the ageing population of Ireland. The article explores the many reasons nurses are leaving the country: mainly the disrespect by management, unfair compensation and the shortage of staff leading to professionals being overworked and eventually experiencing burnout. For many professionals, it has become an issue of their own physical and mental well-being. There are a few recommendations discussed to solve the issue of nurses, which includes a strong push to change perspectives of management and a change of policy by the government. These include retraining healthcare management, an emphasis on hiring and retaining nurses by increasing incentives and making the workload easier to carry.

scholarly journals WHATEVER YOU WANT: INCONSISTENT RESULTS IS THE RULE, NOT THE EXCEPTION, IN THE STUDY OF PRIMATE BRAIN EVOLUTION

2018 ◽  
Author(s):  
Andreas Wartel ◽  
Patrik Lindenfors ◽  
Johan Lind
Keyword(s):  
Body Size ◽  
Brain Evolution ◽  
Data Sets ◽  
Data Set ◽  
Scientific Rigor ◽  
Explanatory Variables ◽  
Primate Brain ◽  
Residual Variation ◽  
The Many ◽  
Brain Data

AbstractPrimate brains differ in size and architecture. Hypotheses to explain this variation are numerous and many tests have been carried out. However, after body size has been accounted for there is little left to explain. The proposed explanatory variables for the residual variation are many and covary, both with each other and with body size. Further, the data sets used in analyses have been small, especially in light of the many proposed predictors. Here we report the complete list of models that results from exhaustively combining six commonly used predictors of brain and neocortex size. This provides an overview of how the output from standard statistical analyses changes when the inclusion of different predictors is altered. By using both the most commonly tested brain data set and a new, larger data set, we show that the choice of included variables fundamentally changes the conclusions as to what drives primate brain evolution. Our analyses thus reveal why studies have had troubles replicating earlier results and instead have come to such different conclusions. Although our results are somewhat disheartening, they highlight the importance of scientific rigor when trying to answer difficult questions. It is our position that there is currently no empirical justification to highlight any particular hypotheses, of those adaptive hypotheses we have examined here, as the main determinant of primate brain evolution.

scholarly journals Metagenome sequencing and 98 microbial genomes from Juan de Fuca Ridge flank subsurface fluids

2016 ◽  
Author(s):  
Sean P Jungbluth ◽  
Jan P Amend ◽  
Michael S Rappé
Keyword(s):  
Juan De Fuca Ridge ◽  
Phylogenomic Analysis ◽  
Data Set ◽  
Microbial Life ◽  
Fuca Ridge ◽  
Juan De Fuca ◽  
Metagenome Sequencing ◽  
The Many ◽  
Ridge Flank ◽  
Informatics Tools

The global deep subsurface biosphere is thought to be one of the largest reservoirs for microbial life on our planet. This study takes advantage of new sampling technologies and couples them with improvements to DNA sequencing and associated informatics tools to reconstruct the genomes of uncultivated Bacteria and Archaea from fluids collected deep within the subseafloor of the Juan de Fuca Ridge. Here, we generated two metagenomes from borehole observatories located 311 meters apart and, using binning tools, retrieved 98 genomes from metagenomes (GFMs) with completeness > 10%. Of the GFMs, 31 were estimated to be > 90% complete, while an additional 17 were > 70% complete. In most instances, estimated redundancy in the GFMs was < 10%. Phylogenomic analysis revealed 53 bacterial and 45 archaeal GFMs and nearly all were distantly related to known cultivates. In the GFMs, abundant bacteria included Chloroflexi, Nitrospirae, Acetothermia (OP1), EM3, Aminicenantes (OP8), Gammaproteobacteria, and Deltaproteobacteria and abundant archaea included Archaeoglobi, Bathyarchaeota (MCG), and Marine Benthic Group E (MBG-E). In this study, we identified the first near-complete genomes from archaeal and bacterial lineages THSCG, MBG-E, and EM3 and, based on the warm, subsurface and hydrothermally-associated from which these groups tend to be found, propose the names, Geothermarchaeota, Hydrothermarchaeota, and Hydrothermae, respectively. The data set presented here are the first description of Juan de Fuca igneous basement microbial GFMs reported and will provide a platform by which one can perform a higher level interrogation of the many uncultivated lineages presented herein.

Indication-Specific Generic Uptake of Imatinib Demonstrates the Impact of Skinny Labeling

2022 ◽  
Author(s):  
Bryan S. Walsh ◽  
Aaron S. Kesselheim ◽  
Ameet Sarpatwari ◽  
Benjamin N. Rome
Keyword(s):  
Patent Protection ◽  
Cross Sectional Study ◽  
Myelogenous Leukemia ◽  
Brand Name ◽  
Generic Competition ◽  
Cross Sectional ◽  
The Us ◽  
Lower Drug ◽  
The Impact ◽  
Brand Name Drugs

PURPOSE Generic competition can be delayed if brand-name manufacturers obtain additional patents on supplemental uses. The US Food and Drug Administration allows generic drug manufacturers to market versions with skinny labels that exclude patent-protected indications. This study assessed whether use of generic versions of imatinib varied between indications included and excluded from the skinny labels. METHODS In this cross-sectional study, we identified adult patients covered by commercial insurance or Medicare Advantage plans who initiated imatinib from February 2016 (first generic availability) to September 2020. Generic versions were introduced with skinny labels that included indications covering treatment of chronic myelogenous leukemia (CML) but excluded treatment of gastrointestinal stromal tumors (GISTs) because of remaining patent protections. Logistic regression was used to determine whether use of generic versus brand-name imatinib differed between patients with a diagnosis of CML or GIST, adjusting for demographics, insurance type, prior use of brand-name drugs, and calendar month. RESULTS Among 2,000 initiators, 934 (47%) had CML and 686 (34%) had GIST. Within 3 years after generics entered the market, more than 90% of initiators in both groups used generic imatinib. Initiation of generic imatinib was slightly lower among patients with GIST than among patients with CML (85% v 88%; adjusted odds ratio 0.56; 95% CI, 0.39 to 0.80; P ≤ .001). CONCLUSION Generic versions of imatinib were dispensed frequently for indications both included (CML) and excluded (GIST) from the skinny labeling, although patients with GIST were slightly less likely to receive a generic version. The skinny labeling pathway allowed generics to enter the market before patent protection for treating patients with GIST expired, facilitating lower drug prices.

scholarly journals Novelty of Active Ingredients in High-Cost Brand-Name Drugs

2020 ◽  
Vol 35 (7) ◽  
pp. 2219-2221 ◽  
Author(s):  
Emily H. Jung ◽  
Ameet Sarpatwari ◽  
Aaron S. Kesselheim
Keyword(s):  
Brand Name ◽  
Active Ingredients ◽  
Brand Name Drugs
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