Associate Research Director of Biopharma and Public Policy, Institute for Health System Innovation and Policy, Questrom School of Business, Boston University
Dissertation Title: "Economic Value of New Treatments for Depression"
This dissertation focuses on a number of important questions in health policy and health economics: What is the impact of illness on public programs and individuals working lives? What is the value of medical innovation given high and growing spending on it for individuals and society? How are new treatments used in clinical practice and what can this say about quality of care and efforts to better rationalize use? All papers focus on depression. This focus was chosen for a variety of reasons. Depression is a prevalent chronic condition nationally and worldwide associated with high rates of disability. New treatments, specifically pharmaceutical treatments, have been a particularly prominent success story since the late 1980s. The availability of newer medications has increased the treated prevalence of depression dramatically over the past decade. New antidepressants are consistently featured in the top 20 pharmaceutical agents for spending in the private and public sectors. Despite this, patients, physicians and policy makers worry over the quality of care provided. Finally, mental health care is a case where the defining issues of health policy and health economics are present to a great degree. Focusing on depression and its treatment allows a graduate student to grapple with the theoretical and empirical challenges to the efficient and equitable provision of care.
The first paper, joint with Richard Frank and Ernie Berndt, investigates the impact of depression on the labor market activities of older workers. We find that depression increases retirement and public program claims to a similar degree as physical illness. The second paper focuses on estimating the economic value of new antidepressant for individuals and society. I find that new antidepressants used for the treatment of major depression provide value for the money spent on them for consumers and society. The third paper, joint with David Cutler and Alisa Busch, investigates the varied uses of antidepressant medications and associated costs for public and private payers. We find that antidepressants are used in the general adult population for a variety of conditions and durations divergent from existing clinical evidence.