Treatment effect heterogeneity, self-selection into RCTs, and racial disparities

In drug development, clinical trials typically aim for a population that is representative of the patients who would be eligible for the treatment. While randomized controlled trials (RCTs) typically focus on measuring the average health impact of a drug across this population, a paper Basu and Gurjal (2020) argue that treatment effect heterogeneity and self-selection…

$1 billion antibiotic venture fund launched

Antibiotic resistance is a problem. One study from Europe found that in 2015 there were 33,110 deaths attributable to antibiotic resistance; accounting for morbidity as well, antibiotic resistance lead to a a decrease of 874,541 disability-adjusted life years. CDC data show that antibiotic resistant bacteria and fungi caused 35,900 deaths in 2019, 12,800 deaths due…

The slow uptake of biosimilars in the US

From Cahan, Kocher, and Bohn in the Health Affairs blog: Since passage of the 2010 “Biosimilars” Act aimed at stimulating non-inferior innovation and competition in therapeutics markets, only 17 agents have been approved, and only seven have made it to market. Why haven’t biosimilars been more attractive? Blackstone et al. (2013) cites 3 key issues:…

Accountable Pharmacy Organizations?

Pharmacists are typically paid for dispensing drugs. They receive a fee to cover the price for acquiring a given drug and a dispensing fee. In general, however, pharmacists are not paid based on patient outcomes. Will that change? Troy Trygstad (2020) argues that value-based reimbursement for pharmacists through accountable pharmacy organizations (APOs) may be the…

Is 340B working?

I have written about the 340b program a number of times on this blog in the past (e.g., “The 340B Program: An Overview“, “340B Facts and Figures“). A new commentary by Thomas and Schulman (2020) in Health Services Research provides some additional information. For instance, why was 340B originally enacted? Blame the Medicaid Drug Rebate…