U.S. county level analysis to determine If social distancing slowed the spread of COVID-19.

OBJECTIVE: To analyze the effectiveness of social distancing in the United States (U.S.). METHODS: A novel cell-phone ping data was used to quantify the measures of social distancing by all U.S. counties. RESULTS: Using a difference-in-difference approach results show that social distancing has been effective in slowing the spread of COVID-19. CONCLUSIONS: As policymakers face the very difficult question of the necessity and effectiveness of social distancing across the U.S., counties where the policies have been imposed have effectively increased social distancing and have seen slowing the spread of COVID-19. These results might help policymakers to make the public understand the risks and benefits of the lockdown.

OBJETIVO: Analizar la efectividad del distanciamiento social en los Estados Unidos. MÉTODOS: Se empleó un método novedoso de contacto con teléfonos celulares (ping) para cuantificar las medidas de distanciamiento social de todos los condados de EE.UU. RESULTADOS: Usando un enfoque de diferencia en diferencias los resultados indicaron que el distanciamiento social ha sido efectivo para reducir la propagación de la COVID-19. CONCLUSIONES: A medida que los responsables de la formulación de políticas se enfrentan a la muy difícil cuestión de la necesidad y la eficacia del distanciamiento social en Estados Unidos, los condados en los que se han impuesto las políticas han aumentado efectivamente el distanciamiento social y en ellos se ha enlentecido la propagación de la COVID-19. Estos resultados pueden ayudar a los responsables de las políticas a hacer comprender a la población los riesgos y beneficios de las restricciones.

Association of authorized generic marketing with prescription drug spending on antidepressants from 2000 to 2011.

OBJECTIVES: Prior research suggests that authorized generic drugs increase competition and decrease prices, but little empirical evidence supports this conclusion. This study evaluated the impact of authorized generic marketing on brand and generic prices. DESIGN: Longitudinal analysis of the household component of the Medical Expenditure Panel Survey. SETTING: Interview panels over 12 years, with a new panel each year. For each panel, 5 rounds of household interviews were conducted over 30 months. PATIENTS OR PARTICIPANTS: Nationally representative sample of the U.S. civilian noninstitutionalized population, focusing on people using 1 of 5 antidepressant drugs that became generically available between 2000 to 2011. INTERVENTION: Drugs and dose/formulations with versus without an authorized generic drug marketed. MAIN OUTCOME MEASURES: Multiple linear regression models with lagged variables evaluated the effect of an authorized generic on average inflation-adjusted brand and generic price, adjusting for payment sources, generic entry time, competitor price, and year. RESULTS: During 2000-2011, annual brand antidepressant utilization decreased from 51.47 to 7.52 million prescriptions, and generic antidepressant utilization increased from 0 to 88.83 million prescriptions. Over time, payment per prescription for brand prescriptions increased 25% overall, and generic payments decreased 70% for all payer types. With unadjusted data, after generic entry the average brand price decreased $0.59 per year with and $3.62 per year without an authorized generic in the market. Average generic prices decreased $10.30 per year with and $8.47 per year without an authorized generic in the market. In multiple regression models with lagged variables adjusted for heteroscedasticity, payer source, time since generic entry, competitor price, and year, authorized generics significantly reduced average payment for generic (-$3.03) and brand (-$60.64) prescriptions, and over time this price change slowly diminished. CONCLUSION: Availability of an authorized generic was associated with reduced average generic and brand price in the antidepressant market, supporting prior evidences.

A county-level study of the effects of state-mandated COVID-19 lockdowns on urban and rural restaurant visits using consumers' cell phone geo-location data.

Aim: US federal, state, and local governments implemented numerous COVID-19 shelter-in-place orders (lockdowns) starting in March 2020 to ensure social distancing regulations and help stop the spread of COVID-19. It is important to know how these lockdowns affected businesses, such as restaurants, in regions that vary in terms of poverty status and geography. In this paper, we analyze the differential changes in rural and urban restaurant visits by the restaurants' NAICS codes following the COVID-19 lockdowns. Our analysis contributes to the public policy literature and helps operational planning for food distribution during a pandemic. Methods: Since urban and rural consumer behavior and food resources are significantly different, it is crucial to conduct a comparative analysis. Our study applies a difference-in-differences model to capture the differential effects lockdowns have on urban and rural restaurants. Results: We find that restaurant visits declined significantly in both rural and urban counties after shelter-at-home orders. The decrease in total restaurant visits was almost twice as high in urban counties as in rural counties. We also find that visits to fast-food restaurants increased in rural counties during shelter-at-home orders. Conclusions: These results contribute to previous studies on the dearth of healthy food in rural and poorer regions, and inform important public policy response in the wake of the COVID-19 pandemic.

Causal connections between socioeconomic disparities and COVID-19 in the USA.

With the increasing use of machine learning models in computational socioeconomics, the development of methods for explaining these models and understanding the causal connections is gradually gaining importance. In this work, we advocate the use of an explanatory framework from cooperative game theory augmented with do calculus, namely causal Shapley values. Using causal Shapley values, we analyze socioeconomic disparities that have a causal link to the spread of COVID-19 in the USA. We study several phases of the disease spread to show how the causal connections change over time. We perform a causal analysis using random effects models and discuss the correspondence between the two methods to verify our results. We show the distinct advantages a non-linear machine learning models have over linear models when performing a multivariate analysis, especially since the machine learning models can map out non-linear correlations in the data. In addition, the causal Shapley values allow for including the causal structure in the variable importance computed for the machine learning model.

A neurobehavioral study on the efficacy of price interventions in promoting healthy food choices among low socioeconomic families.

Given the healthcare costs associated with obesity (especially in childhood), governments have tried several fiscal and policy interventions such as lowering tax and giving rebates to encourage parents to choose healthier food for their family. The efficacy of such fiscal policies is currently being debated. Here we address this issue by investigating how behavioral and brain-based responses in parents with low socioeconomic status change when rebates and lower taxes are offered on healthy food items. We performed behavioral and brain-based experiments, with the latter employing electroencephalography (EEG) acquired from parents while they shop in a simulated shopping market as well as follow up functional magnetic resonance imaging (fMRI) in the more restricted scanner environment. Behavioral data show that lower tax and rebate on healthy foods increase their purchase significantly compared to baseline. Rebate has a higher effect than lower tax treatment. From the EEG and fMRI experiments, we first show that healthy/unhealthy foods elicit least/maximal reward response in the brain, respectively. Further, by offering lower tax or rebate on healthy food items, the reward signal for such items in the brain is significantly enhanced. Second, we demonstrate that rebate is more effective than lower tax in encouraging consumers to purchase healthy food items, driven in part, by higher reward-related response in the brain for rebate. Third, fiscal interventions decreased the amount of frontal cognitive control required to buy healthy foods despite their lower calorific value as compared to unhealthy foods. Finally, we propose that it is possible to titrate the amount of tax reductions and rebates on healthy food items so that they consistently become more preferable than unhealthy foods.

Why trash don't pass? pharmaceutical licensing and safety performance of drugs.

This paper examines how asymmetric information in pharmaceutical licensing affects the safety standards of licensed drugs. Pharmaceutical companies often license potential drug molecules at different stages of drug development from other pharmaceutical or biotechnology companies and complete the remaining of research stages before submitting the new drug application(NDA) to the food and drug administration. The asymmetric information associated with the quality of licensed molecules might result in the molecules which are less likely to succeed to be licensed out, while those with greater potential of success being held internally for development. We identify the NDAs submitted between 1993 and 2004 where new molecular entities were acquired through licensing. Controlling for other drug area specific and applicant firm specific factors, we investigate whether drugs developed with licensed molecules face higher probability of safety based recall and ultimate withdrawal from the market than drugs developed internally. Results suggest the opposite of Akerlof's (Q J Econ 84:488-500, 1970) lemons problem. Licensed molecules rather have less probability of facing safety based recalls and ultimate withdrawal from the market comparing to internally developed drug molecules. This suggests that biotechnology and small pharmaceutical firms specializing in pharmaceutical research are more efficient in developing good potential molecules because of their concentrated research. Biotechnology firms license out good potential molecules because it increases their market value and reputation. In addition, results suggest that both the number of previous approved drugs in the disease area, and also the applicant firms' total number of previous approvals in all disease areas reduce the probability that an additional approved drug in the same drug area will potentially be harmful.

Believe it or not: Health education works.

This study tested the effectiveness of a targeted intervention in the form of healthy food consumption education and discount coupons for healthy food. A field experiment was used to implement healthy food consumption education among low-income families in Alabama. In collaboration with the Sylacauga Alliance for Family Enhancement (SAFE), two grocery stores serving low-income families, interventions such as food consumption education and discount coupons for healthy food were tested. Results show that access to healthy food and education about healthy food consumption encouraged low-income families to purchase healthier food.

U.S. county level analysis to determine If social distancing slowed the spread of COVID-19 / Análisis a nivel de condado para determinar si el distanciamiento social ralentizó la propagación de la COVID-19 en los Estados Unidos

ABSTRACT Objective. To analyze the effectiveness of social distancing in the United States (U.S.). Methods. A novel cell-phone ping data was used to quantify the measures of social distancing by all U.S. counties. Results. Using a difference-in-difference approach results show that social distancing has been effective in slowing the spread of COVID-19. Conclusions. As policymakers face the very difficult question of the necessity and effectiveness of social distancing across the U.S., counties where the policies have been imposed have effectively increased social distancing and have seen slowing the spread of COVID-19. These results might help policymakers to make the public understand the risks and benefits of the lockdown.(AU)

RESUMEN Objetivo. Analizar la efectividad del distanciamiento social en los Estados Unidos. Métodos. Se empleó un método novedoso de contacto con teléfonos celulares (ping) para cuantificar las medidas de distanciamiento social de todos los condados de EE.UU. Resultados. Usando un enfoque de diferencia en diferencias los resultados indicaron que el distanciamiento social ha sido efectivo para reducir la propagación de la COVID-19. Conclusiones. A medida que los responsables de la formulación de políticas se enfrentan a la muy difícil cuestión de la necesidad y la eficacia del distanciamiento social en Estados Unidos, los condados en los que se han impuesto las políticas han aumentado efectivamente el distanciamiento social y en ellos se ha enlentecido la propagación de la COVID-19. Estos resultados pueden ayudar a los responsables de las políticas a hacer comprender a la población los riesgos y beneficios de las restricciones.(AU)

Aspects of research and development contract terms in the bio/pharmaceutical sector.

PURPOSE: The cost of new drug development is increasing every year. Pharmaceutical companies use R&D joint ventures, mergers, and outsource different stages of pharmaceutical R&D activities for a faster and cost minimizing method of innovation. Pharmaceutical companies outsource R&D activities to independent small biotech or pharmaceutical companies that specialize in different stages of pharmaceutical R&D. This chapter examines the determinants of the payment structure of research contracts between large bio/pharmaceutical companies and specialized research firms. METHODS: Determinants of R&D contracts are analyzed using detailed R&D contract data between bio/pharmaceutical companies and independent research firms for 10 years. A multinomial logit model is used in order to understand the determinants of three different types of contracts; royalty contracts, fixed payment contracts, and the mixed contracts. FINDINGS: Under uncertainty, the likelihood of a royalty contract rises for the early stages of the research and with the patent stock of the research firm. It is more likely to observe both royalty and fixed payment if the pharmaceutical client has past contracts with the same research firm. The results also suggest that if Food and Drug Administration (FDA) is more stringent in any disease area in reviewing the new drug application, then the likelihood of signing pure royalty contract decreases. IMPLICATIONS: Understanding the nature of R&D contracts and the effects of FDA's behavior on the pharmaceutical R&D contract is important because these contracts not only affect the cost of new drug invention but also the quality and the rate of invention. VALUE: Results are useful for both the pharmaceutical companies and the economic/business researchers.