HSI funds two new projects in 2022

Economies of Scope in Drug Development

Professor Mert Demirer plans to study economies of scope in prescription drug development. Demirer emphasizes that this topic is an important determinant of innovations, and research and development, yet few studies address this issue. Specifically, he will use detailed drug development data to to quantify how drug development costs or development success rates are affected by the pharmaceutical firm’s existing drug portfolio.

The project will have two research questions:

1. Are there economies of scope in prescription drug development? If so, how large are they?
2. Are economies of scope in prescription drug development large enough to meaningfully affect the prospective antitrust evaluation of mergers?

The second question has become more important as there have been several large mergers and acquisitions in the pharmaceutical industry that have attracted a lot of attention. Demirer notes “If pharmaceutical companies are more efficient at developing drugs and bringing them to market when they have already developed similar drugs, then there are cost efficiencies from horizontal mergers that may offset concerns about market consolidation.”

Enabling Digital Differentiated Care Along the Tuberculosis Treatment Cascade

Professors Jónas Jónasson and Erez Yoeli have been working to develop improved Tuberculosis (TB) treatment support for almost 10 years. Together with Keheala, a digital health startup, they designed a digital health platform to support patients as they undergo treatment. Initially, they tested the platform with two random controlled trials (RCT), which had promising results.

In 2020-21 the team expanded its work to consider how machine learning might be used to enable differentiated care interventions that would improve these results. The insights from that research included:

• They could predict which patients would be relatively unlikely to complete treatment as well as which patients would be unlikely to verify that they’d taken their medication on the next day.
• Prioritizing outreach to these individuals could improve the performance of the Keheala platform without any additional resources.
• Enrolling patients based on their estimated treatment effect pre-enrolment can meaningfully increase the treatment effect of the intervention.

This new HSI grant will allow the researchers to investigate three follow-on questions.

Project 1: Prescriptive Assignment of Care

Predict which patient would benefit from which kind of support on a given day. A specific patient may need more of a nudge, or none at all, on any particular day. For this project, HSI researcher Vivek Farias will join the team.

Project 2: Continuity of Care

Explore whether speaking to the same provider across interactions improves patients’ response to care, and, if so, whether this improvement is more substantial than the possible delay in care that might result from ensuring that patients speak to the same provider across interactions.

Project 3: Post-treatment Outreach

TB Recurrence is an ongoing problem. The research team will determine whether they can identify patients who are likely to experience recurrence. If they can identify these patients, they could provide outreach after treatment has ended to test them for TB and provide additional support.

We are eager to see how these projects progress and will report on these projects’ status in upcoming research updates.