Research

Abstract: This study examines the impact of drug withdrawals due to adverse reactions in Korea and the United States using a difference-in-differences model. The findings reveal heterogeneous effects on adverse reactions incidences and drug costs. For instance, the probability of brain stroke occurrences in Korea declined by 1.6 percentage points following the withdrawal of rosiglitazone, while the probability of heart failure occurrences in the United States decreased by 0.4 percentage points.

Patients who previously utilized the withdrawn drugs did not show significant changes in the frequency of outpatient visits or overall medical service costs. However, there were notable shifts in drug expenses. Following the rosiglitazone withdrawal, patients saved approximately $18 to $40 per month on drugs within the affected therapeutic category. Conversely, after the withdrawal of propoxyphene, patients showed increased expenses for analgesics, starting at $5 and escalating over time. Competitor drugs, both direct (same chemical subgroup) and distant (same therapeutic subgroup), benefited as patients transitioned to both of the alternatives.

Abstract: We examine the effect of government subsidies on long-term care (LTC) on healthcare utilization and health outcomes in Korea, which exhibits one of the fastest rates of population aging. Using a fuzzy regression discontinuity design, we find that the eligibility for subsidized LTC services lowers healthcare expenditures by 6090 USD per year and drug costs by 5640 USD per year. The eligibility also decreases the likelihood of being admitted to a hospital as an inpatient by 30 percentage points. The decrease in healthcare utilization and expenditure is not associated with adverse health outcomes. The eligibility decreases the likelihood of being admitted due to fractures by 7 percentage points, which could be a possible channel for these results. Overall, the net effect of decreased medical expenditures and increased costs associated with the LTC subsidy is inconclusive.

Abstract: Limitations on the physical number of hospital beds and financial stress on hospital systems during the COVID-19 pandemic accelerated a shift from inpatient to outpatient total hip replacement procedures. We evaluate the descriptive changes in patients, hospitals, analgesics, and outcomes for outpatient THR in the time periods before and after the start of the pandemic using the Premier dataset. Comparing the pre and post-COVID periods, we observe that the likelihood of receiving outpatient hip surgery increases where black share of the patient is greater than 20 percent, and Medicare share is greater than 7.5% of the patients. Using the random effects model to alleviate unobserved provider characteristics, patients with neurologic disorders, chronic pulmonary disease, hypothyroidism, arthritic conditions, and anemia were less likely to receive outpatient THR.

Abstract: This paper explores the relationship between the update of drug information on Wikipedia and the pharmaceutical market competition. By creating a panel dataset from web scraped data and using a fixed effect regression model, we find that entry of a generic drug causes increase in the length of negative information about drugs that belong in the same ATC 5 category. The same effect is observed with the probability of FDA’s Blackbox warning getting updated to the Wikipedia page. We do not observe a statistically significant effect for number of competitors at different ATC categories. Entry of a generic drug makes the branded drug less profitable, and this may lead to the strategic update of negative information of the competitor drugs in the ATC 5 category.