IDEAS home Printed from https://ideas.repec.org/a/wly/hlthec/v25y2016i6p723-739.html
   My bibliography  Save this article

Conflicts of Interest in Medical Technology Markets: Evidence from Orthopedic Surgery

Author

Listed:
  • Fabrice Smieliauskas

Abstract

Financial relationships between physicians and industry are vital to biomedical innovation yet create the potential for conflicts of interest in medical practice. I consider an inducement model of the role of financial relationships in health care markets, where consulting payments induce physicians to use more devices of the firms that sponsor them. To test the model, I exploit a policy shock, whereby government monitoring of payments to joint replacement surgeons resulted in declines of over 60% in both total payments and in the number of physicians receiving payments from 2007 to 2008. Using hospital discharge data from three states, I find that the loss of payments leads physicians to switch 7 percentage points of their device utilization from their sponsoring firms' devices to other firms' devices, an effect which is concentrated among surgeons with low switching costs. These results offer support for the inducement model. I also find evidence of an increase in medical productivity following the policy intervention, which suggests conditions under which regulation of financial relationships would be socially beneficial. Copyright © 2015 John Wiley & Sons, Ltd.

Suggested Citation

  • Fabrice Smieliauskas, 2016. "Conflicts of Interest in Medical Technology Markets: Evidence from Orthopedic Surgery," Health Economics, John Wiley & Sons, Ltd., vol. 25(6), pages 723-739, June.
  • Handle: RePEc:wly:hlthec:v:25:y:2016:i:6:p:723-739
    DOI: 10.1002/hec.3177
    as

    Download full text from publisher

    File URL: https://doi.org/10.1002/hec.3177
    Download Restriction: no

    File URL: https://libkey.io/10.1002/hec.3177?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    References listed on IDEAS

    as
    1. Iain M. Cockburn & Rebecca M. Henderson, 1998. "Absorptive Capacity, Coauthoring Behavior, and the Organization of Research in Drug Discovery," Journal of Industrial Economics, Wiley Blackwell, vol. 46(2), pages 157-182, June.
    2. Ho, Vivian, 2002. "Learning and the evolution of medical technologies: the diffusion of coronary angioplasty," Journal of Health Economics, Elsevier, vol. 21(5), pages 873-885, September.
    3. A. Colin Cameron & Douglas L. Miller, 2010. "Robust Inference with Clustered Data," Working Papers 318, University of California, Davis, Department of Economics.
    4. A. Colin Cameron & Douglas L. Miller, 2010. "Robust Inference with Clustered Data," Working Papers 107, University of California, Davis, Department of Economics.
    5. Pei-Yu (Sharon) Chen & Lorin M. Hitt, 2002. "Measuring Switching Costs and the Determinants of Customer Retention in Internet-Enabled Businesses: A Study of the Online Brokerage Industry," Information Systems Research, INFORMS, vol. 13(3), pages 255-274, September.
    6. Stephan, Paula E., 2010. "The Economics of Science," Handbook of the Economics of Innovation, in: Bronwyn H. Hall & Nathan Rosenberg (ed.), Handbook of the Economics of Innovation, edition 1, volume 1, chapter 0, pages 217-273, Elsevier.
    7. Cockburn, Iain M & Henderson, Rebecca M, 1998. "Absorptive Capacity, Coauthoring Behavior, and the Organization of Research in Drug Discovery," Journal of Industrial Economics, Wiley Blackwell, vol. 46(2), pages 157-182, June.
    8. Farrell, Joseph & Klemperer, Paul, 2007. "Coordination and Lock-In: Competition with Switching Costs and Network Effects," Handbook of Industrial Organization, in: Mark Armstrong & Robert Porter (ed.), Handbook of Industrial Organization, edition 1, volume 3, chapter 31, pages 1967-2072, Elsevier.
    9. Zucker, Lynne G & Darby, Michael R & Armstrong, Jeff, 1998. "Geographically Localized Knowledge: Spillovers or Markets?," Economic Inquiry, Western Economic Association International, vol. 36(1), pages 65-86, January.
    Full references (including those not matched with items on IDEAS)

    Citations

    Citations are extracted by the CitEc Project, subscribe to its RSS feed for this item.
    as


    Cited by:

    1. Sara Parker‐Lue, 2020. "The impact of reducing pharmaceutical industry payments on physician prescribing," Health Economics, John Wiley & Sons, Ltd., vol. 29(3), pages 382-390, March.

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Stephan, Paula E., 2010. "The Economics of Science," Handbook of the Economics of Innovation, in: Bronwyn H. Hall & Nathan Rosenberg (ed.), Handbook of the Economics of Innovation, edition 1, volume 1, chapter 0, pages 217-273, Elsevier.
    2. Denisa Mindruta, 2013. "Value creation in university-firm research collaborations: A matching approach," Strategic Management Journal, Wiley Blackwell, vol. 34(6), pages 644-665, June.
    3. Gianluca Fabiano & Andrea Marcellusi & Giampiero Favato, 2020. "Public–private contribution to biopharmaceutical discoveries: a bibliometric analysis of biomedical research in UK," Scientometrics, Springer;Akadémiai Kiadó, vol. 124(1), pages 153-168, July.
    4. Michelle Gittelman & Bruce Kogut, 2003. "Does Good Science Lead to Valuable Knowledge? Biotechnology Firms and the Evolutionary Logic of Citation Patterns," Management Science, INFORMS, vol. 49(4), pages 366-382, April.
    5. Roberto Camerani & Daniele Rotolo & Nicola Grassano, 2018. "Do Firms Publish? A Multi-Sectoral Analysis," SPRU Working Paper Series 2018-21, SPRU - Science Policy Research Unit, University of Sussex Business School.
    6. Jong, Simcha & Slavova, Kremena, 2014. "When publications lead to products: The open science conundrum in new product development," Research Policy, Elsevier, vol. 43(4), pages 645-654.
    7. Azagra-Caro,Joaquín M. & Barberá-Tomás,David & Edwards-Schachter,Mónica, 2015. "The impact of one of the most highly cited university patents: formalisation and localization," INGENIO (CSIC-UPV) Working Paper Series 201502, INGENIO (CSIC-UPV), revised 03 Jan 2017.
    8. Pierre Azoulay & Joshua S. Graff Zivin & Bhaven N. Sampat, 2011. "The Diffusion of Scientific Knowledge across Time and Space: Evidence from Professional Transitions for the Superstars of Medicine," NBER Chapters, in: The Rate and Direction of Inventive Activity Revisited, pages 107-155, National Bureau of Economic Research, Inc.
    9. Berna Beyhan & M. Teoman Pamukçu, 2011. "Nanotechnology research in Turkey: A university-driven achievement," STPS Working Papers 1107, STPS - Science and Technology Policy Studies Center, Middle East Technical University, revised Jul 2011.
    10. Iain M. Cockburn & Rebecca M. Henderson, 2001. "Publicly Funded Science and the Productivity of the Pharmaceutical Industry," NBER Chapters, in: Innovation Policy and the Economy, Volume 1, pages 1-34, National Bureau of Economic Research, Inc.
    11. Simeth, Markus & Raffo, Julio D., 2013. "What makes companies pursue an Open Science strategy?," Research Policy, Elsevier, vol. 42(9), pages 1531-1543.
    12. Simeth, Markus & Lhuillery, Stephane, 2015. "How do firms develop capabilities for scientific disclosure?," Research Policy, Elsevier, vol. 44(7), pages 1283-1295.
    13. Andrew A. Toole & Dirk Czarnitzki, 2009. "Exploring the Relationship Between Scientist Human Capital and Firm Performance: The Case of Biomedical Academic Entrepreneurs in the SBIR Program," Management Science, INFORMS, vol. 55(1), pages 101-114, January.
    14. Michaël Bikard & Keyvan Vakili & Florenta Teodoridis, 2019. "When Collaboration Bridges Institutions: The Impact of University–Industry Collaboration on Academic Productivity," Organization Science, INFORMS, vol. 30(2), pages 426-445, March.
    15. Andrew J. Nelson, 2016. "How to Share “A Really Good Secret”: Managing Sharing/Secrecy Tensions Around Scientific Knowledge Disclosure," Organization Science, INFORMS, vol. 27(2), pages 265-285, April.
    16. Scott Stern, 2004. "Do Scientists Pay to Be Scientists?," Management Science, INFORMS, vol. 50(6), pages 835-853, June.
    17. Roach, Michael & Sauermann, Henry, 2010. "A taste for science? PhD scientists' academic orientation and self-selection into research careers in industry," Research Policy, Elsevier, vol. 39(3), pages 422-434, April.
    18. Manuel Hermosilla & Jorge Lemus, 2018. "Therapeutic Translation of Genomic Science: Opportunities and Limitations of GWAS," NBER Chapters, in: Economic Dimensions of Personalized and Precision Medicine, pages 21-52, National Bureau of Economic Research, Inc.
    19. Grimpe, Christoph, 2012. "Extramural research grants and scientists’ funding strategies: Beggars cannot be choosers?," Research Policy, Elsevier, vol. 41(8), pages 1448-1460.
    20. Michelle Gittelman, 2007. "Does Geography Matter for Science-Based Firms? Epistemic Communities and the Geography of Research and Patenting in Biotechnology," Organization Science, INFORMS, vol. 18(4), pages 724-741, August.

    More about this item

    Statistics

    Access and download statistics

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:wly:hlthec:v:25:y:2016:i:6:p:723-739. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: Wiley Content Delivery (email available below). General contact details of provider: http://www3.interscience.wiley.com/cgi-bin/jhome/5749 .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.