Research
Doctoral Dissertation
Pushing and Pulling Antibiotic Innovation: Evidence from the National Institutes of Health and the Centers for Medicare & Medicaid Services
Bacterial Antimicrobial Resistance (AMR) has been recognized as a global public health problem with 1.27 million worldwide deaths in 2019 attributed to it. To combat the threat of AMR which is forecasted to worsen, policy recommendations have treated antibiotic drug innovation as an integral component. Several policy incentives are currently being explored to “push” and/or “pull” antibiotic drug innovation further with attempts being made to estimate the appropriate size of such incentives. My thesis does a similar exploration of the AMR innovation policy problem with a focus on US public institutions. I use reduced-form, design-based, causal inference techniques to estimate the impacts of existing US policy interventions which impacted the antibiotics market in the recent past.
Working Papers
Do Higher Health Insurance Reimbursements Encourage Antibiotic Innovation?: Evidence from Medicare’s 2007 DRG Restructuring. Read the draft here
I estimate the impact of the 2007 restructuring of Medicare’s Diagnostic-Related Groups (DRGs) in the US on the innovation of antibiotic drug patents. This restructuring had a first-stage effect on average hospital charges per stay (price of stay) reimbursed to hospitals with an average increase of $8,584 per annum for treating the most-severe patient across base-DRGs corresponding to bacterial infectious syndromes for 4 years following the policy change. Hypothesizing passthrough of hospital charges to pharmaceutical usage, I assess whether this first-stage effect in turn caused antibiotic drug innovation by comparing patent trends. But I do not find evidence for these second-stage effects on patent outcomes. To measure drug patent innovation, I attribute US drug patents to DRGs by mapping them to Medical Subject Headings (MeSH) terms in SureChEMBL, a publicly available patents database containing biomedical annotations. This work is salient in light of recent efforts by policymakers to develop novel “pull incentive” mechanisms to hasten antibiotic innovation to ameliorate the burden of bacterial antimicrobial resistance.
The Cost-Effectiveness of Health Aid: An Exploratory Quantitative Analysis
As second author with Victoria Fan, Brian Webster, Karen A. Grépin, David Watkins, and Joseph Dieleman. 2024. Working Paper 700, Center for Global Development. Repec URL
One approach to development assistance for health, or health aid, emphasizes the ex ante selection of cost-effective health interventions, an approach that began with the World Development Report (1993) on Investing in Health and has since been adopted by the Effective Altruism community. But just how much of health aid is cost-effective? In this paper, we examine projects in the Organisation for Economic Co-operation and Development (OECD) Creditor Reporting System, the standard dataset that measures and characterizes development assistance for health, for the years 2019 to 2021, and count the number of projects that refer to interventions from a list of highly cost-effective interventions as defined by the Disease Control Priorities Project, third edition. This exploratory quantitative analysis indicates that 61% of projects used a key word/phrase of a cost-effective intervention. There were 11.9 interventions mapped per project on average. There is little evidence that donors tailor the set of interventions to country income levels by cost-effectiveness. Policymakers may benefit from reviewing the full portfolio of interventions covered by domestic and external resources.
Work in Progress
The Role of Push Incentives in Encouraging Antibiotic Innovation: Evidence from the National Institutes of Health
Mesearch: Personal Experiences and Research Agendas
As second author with Natalia Lamberova and Mikhail Galashin.
Pre-PhD Publication
Structure of Protein Interaction Network Associated With Alzheimer’s Disease Using Graphlet Based Techniques.
As second author with Ahamed Khasim, K. M. Ajith, and T. K. Shajahan. 2022. In Banerjee, S., Saha, A. (eds), Nonlinear Dynamics and Applications. Springer Proceedings in Complexity. Springer, Cham. DOI