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Medical Innovation and Health Disparities / Barton Hamilton, Andrés Hincapié, Emma C. Kalish, Nicholas W. Papageorge.
- Format:
- Book
- Author/Creator:
- Hamilton, Barton.
- Series:
- Working Paper Series (National Bureau of Economic Research) no. w28864.
- NBER working paper series no. w28864
- Language:
- English
- Physical Description:
- 1 online resource: illustrations (black and white);
- Place of Publication:
- Cambridge, Mass. National Bureau of Economic Research 2021.
- Summary:
- Health-maximizing and welfare-maximizing behaviors can be at odds, especially among disadvantaged groups, which can contribute to health disparities. To investigate this point, we estimate a lifecycle model of medication and labor supply decisions using data on HIV-positive men. We use the model to evaluate the disparate consequences of an effective HIV treatment innovation that had harsh side effects: HAART. Measured in lifetime utility gains, HAART disproportionately benefited patients with more education. Lower-educated men were more likely to avoid HAART due to its side effects that interfered with work. To illustrate the wedge between health and welfare, we simulate the effects of a HAART treatment mandate, which mimics assignment to treatment in a clinical trial. The mandate improves health, which would be viewed as a success in a randomized trial. However, clinical trials, which often focus solely on health outcomes, can mask downsides of the treatment including its distributional consequences: the mandate increases inequality as measured by lifetime welfare because lower-educated men are more likely to stop working due to HAART-induced side effects. In contrast, a counterfactual policy simulation that provides a non-labor income subsidy increases HAART adoption and improves health, especially among lower-education individuals. Broadly, our study illustrates that the evaluation of medical innovations may be incomplete absent an understanding of their distributional consequences across different groups of patients.
- Notes:
- Print version record
- May 2021.
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