Health economics最新文献_第7页

Strategic Delay and Bargaining Over Public Insurance Coverage for Drugs in Australia. 澳大利亚药品公共保险覆盖的战略延迟与讨价还价。

IF 2 3区医学

Health economics Pub Date : 2026-06-01 Epub Date: 2026-03-12 DOI: 10.1002/hec.70095

Jing Jing Li, Anthony Harris

{"title":"Strategic Delay and Bargaining Over Public Insurance Coverage for Drugs in Australia.","authors":"Jing Jing Li, Anthony Harris","doi":"10.1002/hec.70095","DOIUrl":"10.1002/hec.70095","url":null,"abstract":"Public funding for pharmaceuticals often follows repeated negotiation between manufacturers and a public agency, yet little empirical work examines how the timing of agreement reflects the economic structure of these interactions. Using a duration model of negotiations in Australia from 2005 to 2018, we assess whether observed patterns of delay and agreement align with dynamic bargaining theory under incomplete information. Agreements from 634 submissions for 400 therapies required a median of 16 months, and 71% of negotiation rounds ended without agreement. Therapies with lower expected value to the agency-reflected in higher incremental cost per QALY, greater budget impact, or evidence uncertainty-experienced longer delays and lower agreement rates, while those with strong clinical importance, perceived need, or elevated public interest were listed more quickly. Delays also varied across therapeutic classes and with a therapy's position in the sequencing of available treatments. The observed patterns point to a systematic listing rule in which therapies are funded when expected health gains justify their opportunity costs. They also support the view that the timing of agreement reflects strategic negotiation under uncertainty, not simply procedural delay.","PeriodicalId":12847,"journal":{"name":"Health economics","volume":" ","pages":"1005-1018"},"PeriodicalIF":2.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13126100/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147443456","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

How do US Adults Who Vape Choose Among Different E-Cigarette (EC) Models and Cigarettes in Response to Prices and Taxes 美国吸电子烟的成年人如何根据价格和税收在不同的电子烟（EC）型号和香烟中做出选择。

IF 2.4 3区医学

Health economics Pub Date : 2026-06-01 Epub Date: 2026-04-15 DOI: 10.1002/hec.70097

Shaoying Ma, Sooa Ahn, Hojin Park, Qian Yang, John F. P. Bridges, Ce Shang

{"title":"How do US Adults Who Vape Choose Among Different E-Cigarette (EC) Models and Cigarettes in Response to Prices and Taxes","authors":"Shaoying Ma, Sooa Ahn, Hojin Park, Qian Yang, John F. P. Bridges, Ce Shang","doi":"10.1002/hec.70097","DOIUrl":"10.1002/hec.70097","url":null,"abstract":"States continue to impose E-Cigarette (EC) taxes without clear evidence of the cross-price elasticities between multiple EC types and between ECs and cigarettes. Moreover, existing literature focused on EC sales or prevalence outcomes instead of consumption units of various EC types. We examined how EC and cigarette consumption respond to prices and taxes and estimated own-price and cross-price elasticities for multiple EC types using a nationally representative volumetric choice experiment (VCE) of US adults who vaped ECs in the past 30 days. In the VCE, participants made purchases for monthly consumption in response to changing tax and price levels in 9 choice sets, and 700 people were recruited and answered VCE questions during 2023. Each choice set includes disposables, pod devices, pod refill packs, pod starter kits, tank devices, e-liquids, and cigarettes. Zero-inflated Poisson model was used to estimate price and tax impacts, as well as own- and cross-price elasticities of demand for these products. Increasing taxes and prices (e.g., minimum pricing floor) reduces EC consumption among US adults who vape, and different EC types are economic substitutes. Platform goods (e.g., tank devices and e-liquids, pod devices and refill packs) are economic complements. Increasing EC prices likely does not lead to higher cigarette consumption among the general adult EC-using population. The design of EC taxes by EC models and components may be needed given their complex economic relationships.","PeriodicalId":12847,"journal":{"name":"Health economics","volume":"35 7","pages":"1104-1117"},"PeriodicalIF":2.4,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/hec.70097","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147689861","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Gambling and Substance Use: Early Evidence From Sports Betting Laws. 赌博和物质使用：来自体育博彩法的早期证据。

IF 2 3区医学

Health economics Pub Date : 2026-06-01 Epub Date: 2026-03-11 DOI: 10.1002/hec.70088

Kabir Dasgupta, Keshar Ghimire

引用次数: 0

Unintended Consequences of Life-Saving Pharmaceutical Innovations: How HAART Led to the Resurgence of Syphilis 挽救生命的药物创新的意外后果：HAART是如何导致梅毒死灰复燃的？

IF 2.4 3区医学

Health economics Pub Date : 2026-06-01 Epub Date: 2026-04-22 DOI: 10.1002/hec.70100

David Beheshti, Scott Cunningham, Nir Eilam

{"title":"Unintended Consequences of Life-Saving Pharmaceutical Innovations: How HAART Led to the Resurgence of Syphilis","authors":"David Beheshti, Scott Cunningham, Nir Eilam","doi":"10.1002/hec.70100","DOIUrl":"10.1002/hec.70100","url":null,"abstract":"Syphilis, a sexually transmitted infection that can lead to serious health complications, was almost eliminated in the United States by 2000. But since then, its incidence began to increase, recently reaching a 60-year peak. We suggest that the introduction of the highly active antiretroviral therapy (HAART) drug regimen, which transformed HIV from a terminal condition into a manageable chronic disease, is partly responsible, as people living with and without HIV altered their sexual behavior after the introduction of HAART. To test this empirically, we exploit variation in HAART takeup based on spatial variation in pre-HAART AIDS prevalence, sex, and time in a triple differences framework. We find that a one standard deviation increase in the pre-HAART AIDS prevalence rate led to a 17.8 percent increase in the syphilis incidence rate, and that in the absence of HAART, there would have been 81 percent fewer syphilis cases between 1996 and 2008. These results highlight the need to consider unintended consequences that could stem from behavioral changes following the introduction of life-saving medical innovations.","PeriodicalId":12847,"journal":{"name":"Health economics","volume":"35 7","pages":"1118-1130"},"PeriodicalIF":2.4,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/hec.70100","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147769783","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

The Mental Health Impact of the COVID-19 Pandemic on Health and Social Care Workers. COVID-19大流行对卫生和社会护理工作者心理健康的影响

IF 2 3区医学

Health economics Pub Date : 2026-06-01 Epub Date: 2026-03-09 DOI: 10.1002/hec.70090

Victoria Serra-Sastre, Jaime Pinilla, Wasana Kalansooriya

{"title":"The Mental Health Impact of the COVID-19 Pandemic on Health and Social Care Workers.","authors":"Victoria Serra-Sastre, Jaime Pinilla, Wasana Kalansooriya","doi":"10.1002/hec.70090","DOIUrl":"10.1002/hec.70090","url":null,"abstract":"The COVID-19 pandemic placed exceptional strain on essential services, raising urgent concerns about the mental well-being of workers in critical sectors. This study examines the short- and medium-term effects of the COVID-19 pandemic on the mental health of health and social care (HSC) workers in the UK relative to other occupational groups. Using data from the UK Household Longitudinal Study and measuring mental health via the General Health Questionnaire (GHQ), we apply a difference-in-differences strategy, where both groups could be treated only in the second period (a pre-post design), to investigate whether HSC workers experienced distinct mental health trajectories compared to other key workers (KWs) and workers in non-essential sectors (non-KWs). The results for the immediate post-pandemic period (April-November 2020) show no significant differences in mental health for HSC workers compared with either comparator worker groups. Medium-term outcomes remained statistically insignificant across occupational comparisons. Additional analyses of individual GHQ items and potential mechanisms (financial stability and social isolation) suggest limited heterogeneous effects for each worker group using yearly data. While all studied groups exhibited some deterioration in mental health after 2020, HSC workers' trajectories largely mirrored those of other KWs and non-KWs, suggesting that factors such as stable employment and financial security may have cushioned the psychological impact for this sector.","PeriodicalId":12847,"journal":{"name":"Health economics","volume":" ","pages":"960-977"},"PeriodicalIF":2.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13126099/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147389663","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Information Shocks, Legal Liability and Physician Decisions. 信息冲击、法律责任和医生决定。

IF 2 3区医学

Health economics Pub Date : 2026-06-01 Epub Date: 2026-03-03 DOI: 10.1002/hec.70096

David Mushinski, Sammy Zahran

{"title":"Information Shocks, Legal Liability and Physician Decisions.","authors":"David Mushinski, Sammy Zahran","doi":"10.1002/hec.70096","DOIUrl":"10.1002/hec.70096","url":null,"abstract":"Physician adoption of new information about a medical procedure can affect patient outcomes. Medical malpractice law may influence physician use of such information. We analyze how physician reactions to information shocks regarding vaginal births after cesarean sections (VBACs) in the 1990s were mediated by tort reform and the standard used in malpractice claims to determine a physician's duty of care to patients. Differentiating states according to whether they capped non-economic damages in malpractice claims (Caps) and whether they defined the duty of care using a national or a local reference point, we analyze how physicians under the four legal regimes reacted to a series of adverse information shocks regarding VBACs over the period. Our results suggest that physicians whose duty of care is determined by standard practices nationwide are less likely to adopt innovations which have not yet been incorporated into those practices and more likely to adopt innovations once they are incorporated into those practices. Caps may moderate these effects. Our results also suggest intuitive heterogeneity in the effects of legal regime on physician decisions.","PeriodicalId":12847,"journal":{"name":"Health economics","volume":" ","pages":"896-909"},"PeriodicalIF":2.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13126103/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147348155","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Competing Demographic Drivers of Hospital Expenditures: Coexistence of the Red Herring and the Steepening Effects. 医院支出的竞争人口驱动因素：红鲱鱼和陡峭效应的共存。

IF 2 3区医学

Health economics Pub Date : 2026-06-01 Epub Date: 2026-03-07 DOI: 10.1002/hec.70092

Malene Kallestrup-Lamb, Alexander O K Marin, Jes Søgaard

{"title":"Competing Demographic Drivers of Hospital Expenditures: Coexistence of the Red Herring and the Steepening Effects.","authors":"Malene Kallestrup-Lamb, Alexander O K Marin, Jes Søgaard","doi":"10.1002/hec.70092","DOIUrl":"10.1002/hec.70092","url":null,"abstract":"The fiscal sustainability of healthcare systems is increasingly strained by aging populations with two competing hypotheses dominating the literature. The Red Herring Hypothesis suggests that healthcare expenditures are driven more by proximity to death than by chronological age, while the Steepening Hypothesis examines whether expenditures increase faster for older individuals over time. Nevertheless, these two frameworks have traditionally been studied independently rather than in conjunction. This paper offers a unified econometric model, allowing for a rigorous assessment of their concurrent validity and interaction. Using comprehensive register-based monthly somatic hospital expenditure data for the entire Danish population from 2002 to 2017, we provide robust evidence that both Red Herring and Steepening effects operate simultaneously. Although Red Herring effects modestly mitigate the expenditure burden of an increasingly older population, they are substantially outweighed by pronounced Steepening effects, which account for nearly 60% of hospital expenditure growth during the observation period. Through a novel decomposition method, we identify a previously unrecognized interaction between these phenomena, a Red Herring Steepening effect, which accelerates expenditure growth in the final years of life for older individuals. Our findings suggest that healthcare systems face considerably greater fiscal challenges from population aging than previously recognized under the Red Herring Hypothesis alone.","PeriodicalId":12847,"journal":{"name":"Health economics","volume":" ","pages":"929-946"},"PeriodicalIF":2.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13126104/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147372504","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Further Findings on the Intergenerational Transmission of Alcohol Consumption 酒精消费代际传递的进一步发现。

IF 2.4 3区医学

Health economics Pub Date : 2026-06-01 Epub Date: 2026-03-22 DOI: 10.1002/hec.70084

Sergey Alexeev

{"title":"Further Findings on the Intergenerational Transmission of Alcohol Consumption","authors":"Sergey Alexeev","doi":"10.1002/hec.70084","DOIUrl":"10.1002/hec.70084","url":null,"abstract":"Using 43,817 parent–child pairs from 23 waves of the HILDA Survey, I study the intergenerational transmission of alcohol use within a rational model of trait transmission. Transmission is predominantly same-sex: the mother–daughter elasticity is 0.10 and the father–son elasticity is 0.09; there is no father–daughter effect. Influence peaks at ages 15–17 and re-emerges at 28–37 when offspring become parents; mothers also affect sons at both junctures. Comparisons with non-birth (adoptee-style) dyads show similar mother–daughter transmission, indicating norm-based rather than biological channels. Identification concerns are addressed with placebo reshuffling and copula-based corrections; estimates are robust across specifications. Men who remain childless are more likely to mirror maternal drinking, which—together with declining fertility and earlier alcohol-control policies—helps explain cohort declines in male drinking. The interpretation is that parental norms anchor behavior at identity-forming and role-transition ages, with strong persistence thereafter. Policy should target these windows with gender-specific, couple-level interventions alongside population levers on price, availability and marketing.","PeriodicalId":12847,"journal":{"name":"Health economics","volume":"35 7","pages":"1056-1072"},"PeriodicalIF":2.4,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/hec.70084","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147493838","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Trends in Selection Into Medicare Advantage. 选择医疗保险优势的趋势。

IF 2 3区医学

Health economics Pub Date : 2026-06-01 Epub Date: 2026-03-09 DOI: 10.1002/hec.70091

Anuj Gangopadhyaya, Bowen Garrett

{"title":"Trends in Selection Into Medicare Advantage.","authors":"Anuj Gangopadhyaya, Bowen Garrett","doi":"10.1002/hec.70091","DOIUrl":"10.1002/hec.70091","url":null,"abstract":"Medicare Advantage (MA) enrollment more than doubled from 2013 to 2023, raising concerns about risk selection, spending, and the continued use of traditional Medicare (TM) spending as a benchmark for MA payment. This study examines trends in selection into MA from 2009 to 2020 using administrative and survey data from the Medicare Current Beneficiary Survey. For each survey year, we estimate a regression model of Part A and B spending among TM enrollees based on demographic characteristics, self-reported health status, limitations in activities of daily living, and enrollee group type (e.g., dual eligible, institutionalized, disabled). We apply this model to MA enrollees to estimate their predicted TM spending. We find that since 2017, MA enrollees have had higher predicted costs than TM enrollees-5-6% higher from 2017 to 2020-driven largely by the growing share of dual eligibles in MA. Within enrollee group type, however, we observe little evidence of differential selection. We further use the model results from just our baseline year, 2009, to predict both MA and TM spending in each subsequent year. We find that although MA enrollee characteristics did not trend observably healthier or sicker over this period, TM enrollees' characteristics appear to have shifted in ways associated with lower predicted spending over time. These findings suggest that the nature of selection into MA has qualitatively shifted over recent years and raises further questions about how well the current risk adjustment system reflects appropriate differences in risk as the enrollee characteristics in these groups continue to diverge.","PeriodicalId":12847,"journal":{"name":"Health economics","volume":" ","pages":"978-994"},"PeriodicalIF":2.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147389723","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Improving Healthcare Utilization in Retired Self-Employed Workers: Evidence From an Experiment in France 提高退休个体经营者的医疗保健利用：来自法国实验的证据。

IF 2.4 3区医学

Health economics Pub Date : 2026-06-01 Epub Date: 2026-03-24 DOI: 10.1002/hec.70101

Estelle Augé, Nicolas Sirven

引用次数: 0