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Essays on Innovation in the Medical Device Industry- [electronic resource]
Essays on Innovation in the Medical Device Industry- [electronic resource]
상세정보
- 자료유형
- 학위논문
- Control Number
- 0016930978
- International Standard Book Number
- 9798380123396
- Dewey Decimal Classification Number
- 614
- Main Entry-Personal Name
- Everhart, Alexander Oljace.
- Publication, Distribution, etc. (Imprint
- [S.l.] : University of Minnesota., 2021
- Publication, Distribution, etc. (Imprint
- Ann Arbor : ProQuest Dissertations & Theses, 2021
- Physical Description
- 1 online resource(129 p.)
- General Note
- Source: Dissertations Abstracts International, Volume: 85-02, Section: B.
- General Note
- Advisor: Karaca-Mandic, Pinar.
- Dissertation Note
- Thesis (Ph.D.)--University of Minnesota, 2021.
- Restrictions on Access Note
- This item must not be sold to any third party vendors.
- Summary, Etc.
- 요약This dissertation includes three empirical papers on the development and adoption of medical devices in the United States. Economists attribute as much as half of recent gains in life expectancy in the United States to the use of new medical technologies. When developing medical technologies, manufacturers must consider the "total product lifecycle" of devices, spanning from development costs to regulatory approval to insurer coverage and ultimately patient and physician adoption. The three chapters of this dissertation examine different stages of the total product lifecycle for medical devices.In Chapter 1, I study how medical device firms change their investments in research and develop following external shocks to production costs. Using damage to device manufacturing facilities caused by Puerto Rican hurricanes as a natural experiment, I find that increases in storm exposure cause firms to spend less on research and development and bring fewer medical devices to market. I also find that devices brought to market following storms are cited in competitor regulatory submissions no more or less often than the average medical device. This suggests that device firms do not meaningfully target more or less scientifically innovative projects at the margin when reducing investments in research and development.In Chapter 2, I describe the availability of cost-effectiveness analyses for medical devices in the United States. Cost-effectiveness analyses are not consistently used by insurers when making coverage decisions in the United States. I find that one of the barriers to using cost-effectiveness analyses is the timing of when analyses become available. Cost-effectiveness analyses are not available until several years after regulatory approval.In Chapter 3, I examine the effect of industry payments on physicians' adoption of Medtronic's Micra leadless pacemaker in fee-for-service Medicare. Leadless pacemakers have lower complication rates but a higher cost compared to traditional leaded pacemakers. I find that physicians who receive more payments from pacemaker manufacturers are more likely to adopt leadless pacemakers. However, this relationship is not robust to either physician fixed effects or an instrumental variables analysis predicting receipt of manufacturer payments as a function of distance from Medtronic headquarters.
- Subject Added Entry-Topical Term
- Public health.
- Subject Added Entry-Topical Term
- Health care management.
- Subject Added Entry-Topical Term
- Finance.
- Index Term-Uncontrolled
- Cost-effectiveness analysis
- Index Term-Uncontrolled
- Health economics
- Index Term-Uncontrolled
- Health services research
- Index Term-Uncontrolled
- Innovation
- Index Term-Uncontrolled
- Medical device
- Index Term-Uncontrolled
- Physician decision making
- Added Entry-Corporate Name
- University of Minnesota Health Services Research Policy and Administration
- Host Item Entry
- Dissertations Abstracts International. 85-02B.
- Host Item Entry
- Dissertation Abstract International
- Electronic Location and Access
- 로그인을 한후 보실 수 있는 자료입니다.
- Control Number
- joongbu:639192
MARC
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■1001 ▼aEverhart, Alexander Oljace.
■24510▼aEssays on Innovation in the Medical Device Industry▼h[electronic resource]
■260 ▼a[S.l.]▼bUniversity of Minnesota. ▼c2021
■260 1▼aAnn Arbor▼bProQuest Dissertations & Theses▼c2021
■300 ▼a1 online resource(129 p.)
■500 ▼aSource: Dissertations Abstracts International, Volume: 85-02, Section: B.
■500 ▼aAdvisor: Karaca-Mandic, Pinar.
■5021 ▼aThesis (Ph.D.)--University of Minnesota, 2021.
■506 ▼aThis item must not be sold to any third party vendors.
■520 ▼aThis dissertation includes three empirical papers on the development and adoption of medical devices in the United States. Economists attribute as much as half of recent gains in life expectancy in the United States to the use of new medical technologies. When developing medical technologies, manufacturers must consider the "total product lifecycle" of devices, spanning from development costs to regulatory approval to insurer coverage and ultimately patient and physician adoption. The three chapters of this dissertation examine different stages of the total product lifecycle for medical devices.In Chapter 1, I study how medical device firms change their investments in research and develop following external shocks to production costs. Using damage to device manufacturing facilities caused by Puerto Rican hurricanes as a natural experiment, I find that increases in storm exposure cause firms to spend less on research and development and bring fewer medical devices to market. I also find that devices brought to market following storms are cited in competitor regulatory submissions no more or less often than the average medical device. This suggests that device firms do not meaningfully target more or less scientifically innovative projects at the margin when reducing investments in research and development.In Chapter 2, I describe the availability of cost-effectiveness analyses for medical devices in the United States. Cost-effectiveness analyses are not consistently used by insurers when making coverage decisions in the United States. I find that one of the barriers to using cost-effectiveness analyses is the timing of when analyses become available. Cost-effectiveness analyses are not available until several years after regulatory approval.In Chapter 3, I examine the effect of industry payments on physicians' adoption of Medtronic's Micra leadless pacemaker in fee-for-service Medicare. Leadless pacemakers have lower complication rates but a higher cost compared to traditional leaded pacemakers. I find that physicians who receive more payments from pacemaker manufacturers are more likely to adopt leadless pacemakers. However, this relationship is not robust to either physician fixed effects or an instrumental variables analysis predicting receipt of manufacturer payments as a function of distance from Medtronic headquarters.
■590 ▼aSchool code: 0130.
■650 4▼aPublic health.
■650 4▼aHealth care management.
■650 4▼aFinance.
■653 ▼aCost-effectiveness analysis
■653 ▼aHealth economics
■653 ▼aHealth services research
■653 ▼aInnovation
■653 ▼aMedical device
■653 ▼aPhysician decision making
■690 ▼a0501
■690 ▼a0573
■690 ▼a0508
■690 ▼a0769
■71020▼aUniversity of Minnesota▼bHealth Services Research, Policy and Administration.
■7730 ▼tDissertations Abstracts International▼g85-02B.
■773 ▼tDissertation Abstract International
■790 ▼a0130
■791 ▼aPh.D.
■792 ▼a2021
■793 ▼aEnglish
■85640▼uhttp://www.riss.kr/pdu/ddodLink.do?id=T16930978▼nKERIS▼z이 자료의 원문은 한국교육학술정보원에서 제공합니다.
■980 ▼a202402▼f2024
