Emergent challenges and opportunities in drug discovery and commercialization.

We review medical economics literature presented at the 2023 annual AEA-ASSA convention, the largest gathering of economists worldwide. Pharmacoeconomic papers addressed a wide range of issues, including gender and racial gaps in clinical trials, hospital credit financing, drug rebates, covid-19 vaccine equality, and the opioid epidemic. Yet, they had some common identifiable themes.

The insurance role in workplace health promotion: a comparative analysis of the United States and the Philippines.

There is a void in the health promotion literature concerning the role of health insurance. This study offers a comparative analysis of employee health insurance in the United States and the Philippines. As the first study of its kind, it examines insurance as an instrument of health promotion policy for improving population health and reducing healthcare costs.

Cross-country experiences and lessons in nutraceutical health marketing in the United States, China, and India.

The distinction between food and drugs has blurred in recent years with a new - and novel - health paradigm representing a hybrid of "nutrition" and "pharmaceuticals." Nutraceuticals are formulated or processed to satisfy dietary requirements arising from physical or physiological conditions, and to treat certain diseases. This study examines the complex interface between the regulatory framework and nutraceutical marketing by drawing from the experiences of three leading global producers and markets: the United States, China, and India.

Continuity and change in the drug supply chain: actors, actions, and aversions.

Aim: The pharmaceutical or drug supply chain is the means through which prescription medicines are manufactured, stocked, and delivered to consumers. How the complexity and fragmentation of this supply chain shape or reshape the decisions and courses of action as well as risk aversions of its actors (stakeholders) is the question we address in reviewing recent literature presented at the 2021 AEA-ASSA economics convention. In doing so, we identify key aspects or dimensions of the supply chain that remain unexplored or under-explored in the empirical literature.

Effects of innovation and insurance coverage on price elasticity of demand for prescription drugs: some empirical lessons in pharmacoeconomics.

Aim: Prescription drug prices in the United States are considered rather extreme. Americans spend over $460 billion on drugs annually, or almost 17 percent of total national healthcare spending. How innovation incentives and insurance coverage drive pricing, diffusion, and utilization of drugs, under conditions of risk and competition, are multi-dimensional issues in medical economics that remain under-explored in the current empirical literature.

Incentives and disincentives to drug innovation: evidence from recent literature.

Drug innovation is strongly driven by economic incentives. How these incentives work in determining or changing the level of activity of innovators and the direction of their innovation remains understudied. We seek to address these issues in reviewing recent literature on drug innovation, which offers one major unifying theme of pharmacoeconomic scholarship presented at the 2019 AEA-ASSA annual convention.

Clinical trials with multiple endpoints can establish a correlation, but not (yet) causality, between dietary supplementation with omega-3 fatty acids and keratoconjunctivitis sicca.

Aim: We review clinical evidence of therapeutic efficacy and effectiveness of omega-3 fatty acids (omega-3s) in keratoconjunctivitis sicca, colloquially known as dry eye disease. In doing so, we identify relevant literature to address the following questions: (1) What definitive guidance can clinical evidence offer eye physicians and their patients? (2) What aspects of omega-3 supplementation lack definitive evidence, and how might economic assessments help?

Methods: A targeted and systematic search strategy based on PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) was designed in this study for refereed clinical trials of omega-3s in dry eye treatment. Four key databases were accessed.

Bringing the patient back in: behavioral decision-making and choice in medical economics.

We explore the behavioral methodology and "revolution" in economics through the lens of medical economics. We address two questions: (1) Are mainstream economic assumptions of utility-maximization realistic approximations of people's actual behavior? (2) Do people maximize subjective expected utility, particularly in choosing from among the available options? In doing so, we illustrate-in terms of a hypothetical experimental sample of patients with dry eye diagnosis-why and how utility in pharmacoeconomic assessments might be valued differently by patients when subjective psychological, social, cognitive, and emotional factors are considered. While experimentally-observed or surveyed behavior yields stated (rather than revealed) preferences, behaviorism offers a robust toolset in understanding drug, medical device, and treatment-related decisions compared to the optimizing calculus assumed by mainstream economists.

Is medical treatment of Alcohol Withdrawal Syndrome a Stag Hunt? Challenges and opportunities in managing risk and uncertainty in addiction cessation.

Purpose: While the individual and social costs of alcoholism or alcohol use disorder are well established, few are aware that medical problems can arise during detoxification, some of which can be life-threatening. This study determines if sustained treatment for Alcohol Withdrawal Syndrome (AWS) might be based on the strategic choices and expectations of patients and health care providers alike, as well as the risk mitigation options available to them.

Design/approach: AWS was modeled as a Stag Hunt to explain both risk and decision-making in medical treatments for detoxification, since it can deduce a set of equilibrium strategies available to both patient and provider.

Hospice or community network? Choices in end-of-life care in Jamaica.

Aim: Now considered a subspecialty of medicine and nursing, palliative care is a critical aspect of healthcare at the end of life. National and international healthcare agencies typically attribute its slow or haphazard growth in developing countries to various resource constraints. However, this study provides evidence of the substantial and widening gap between policy advocacy and patient choices in end-of-life care.

The 21st Century Cures Act: pharmacoeconomic boon or bane?

Barriers to entry in healthcare markets constitute one of the overriding concerns of health economists. The recent enactment of the 21st Century Cures Act in the United States reduces statutory entry barriers to the discovery, development, testing, and licensing of drugs and medical devices. Drug and device makers also see the burdensome and time-consuming requirements of the Food and Drug Administration?s approval process as key barriers to lowering the costs of their products, considering it takes a decade of research amounting to $1 billion just to bring a single drug to the market.

Which moral hazard? Health care reform under the Affordable Care Act of 2010.

Purpose - Moral hazard is a concept that is central to risk and insurance management. It refers to change in economic behavior when individuals are protected or insured against certain risks and losses whose costs are borne by another party. It asserts that the presence of an insurance contract increases the probability of a claim and the size of a claim.

A Game-Theoretic Model of Marketing Skin Whiteners.

Empirical studies consistently find that people in less developed countries tend to regard light or "white" skin, particularly among women, as more desirable or superior. This is a study about the marketing of skin whiteners in these countries, where over 80 percent of users are typically women. It proceeds from the following premises: a) Purely market or policy-oriented approaches toward the risks and harms of skin whitening are cost-inefficient; b) Psychosocial and informational factors breed uninformed and risky consumer choices that favor toxic skin whiteners; and c) Proliferation of toxic whiteners in a competitive buyer's market raises critical supplier accountability issues.

Rents From the Essential Health Benefits Mandate of Health Insurance Reform.

The essential health benefits mandate constitutes one of the most controversial health care reforms introduced under the U.S. Affordable Care Act of 2010.

Autonomy and paternalism in medical e-commerce.

One of the overriding interests of the literature on health care economics is to discover where personal choice in market economies end and corrective government intervention should begin. Our study addresses this question in the context of John Stuart Mill's utilitarian principle of harm. Our primary objective is to determine whether public policy interventions concerning more than 35,000 online pharmacies worldwide are necessary and efficient compared to traditional market-oriented approaches.

The skin whitening industry in the Philippines.

Skin whitening is a big and booming industry in many developing countries. Its popularity owes mainly to post-colonial, internalized racism. This study examines whether government intervention is necessary and more efficient than market-driven approaches in addressing the health risks and harms associated with skin whitening.

A case study of infant health promotion and corporate marketing of milk substitutes.

The mismatch between the demand for, and supply of, health products has led to the increasing involvement of courts worldwide in health promotion and marketing. This study critically examines the implementation of one country's Milk Code within the framework of the International Code of Marketing of Breast-Milk Substitutes, and the efficacy of the judicial process in balancing corporate marketing and state regulatory objectives. Drawing upon the Philippine experience with its own Milk Code, it evaluates the capacities of courts to determine policy costs and risks against the benefits of delineating and containing corporate marketing strategies for milk substitutes and supplements.

Price deflation and the underground organ economy in the Philippines.

Background: This is the first in-depth study of the illicit human organ trade in the Philippines. The question for analytical investigation is why the underground organ commerce thrives, despite meager support and compensation for commercial donors (or vendors).

Methods: Quantitative survey results were obtained from a probability sample of living Filipino kidney vendors (P = 0.

Kidney black markets and legal transplants: are they opposite sides of the same coin?

Objectives: This study investigates why the illegal traffic of kidneys exists and remains resilient in the Philippines. It also evaluates the efficacy of the legal and regulatory framework for kidney (and organ) transplantation, and the corresponding implications for health policy. The experiences of comparable countries are noted.

Promoting social welfare through oral health: New Jersey's fluoridation experience.

This study examines the contentious public health policy of treating community water with fluoride in the United States. The question for scholarly investigation is why water fluoridation has been unsuccessful in several parts of the United States relative to the rest. It addresses this question by looking into the processes of scientific discovery and information dissemination, benefits and risks of science-based health policy, related issues of provision and production, and spatial dimensions of policy development.

Is it really medicine? The traditional and alternative medicine act and informal health economy in the Philippines.

This article examines one developing country's (Philippines) experience in legalizing the age-old but controversial practice and use of traditional, complementary, and alternative medicine (TCAM). The case studies in this article shed light on the problems, challenges, and opportunities offered by herbal therapies, natural products, and alternative healing methods, and the policy context in which they exist. The study finds that normative, axiological, and ethical considerations underlie the legitimacy of TCAM.

Public health policy and medical missions in the Philippines: the case of oral--facial clefting.

This article examines the critical role of medical missions as alternative or proxy health delivery agencies in developing countries like the Philippines. Why and how they exist, what they can and cannot do, how they interact with the for-profit and public health sectors, and what challenges they face in the context of underdevelopment are analyzed by using a proposed structural- behavioral framework. We find that these missions can offer short-term benefits to specialized public health problems, such as oral-facial clefting, but depend on public and private partnerships and resources for long-term solutions.